WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo. N.Y.:

[Illustration]

_Gentlemen_--I can bear testimony to the removal of the difficulty for

which you treated me, for I had been to experts in Philadelphia and they

did not know how to perform the operation, and said I could not be

cured. I was treated by experts in Albany and other cities, but all for

no use. I went to the Invalids' Hotel and Surgical Institute and was

operated upon and find I am cured. The treatment in every other respect

was good; everything was done to make patients happy and pleasant; the

best of care and attention was paid to all.

Yours truly,

W. McGOWAN,

Orbisonia, Huntingdon Co., Pa.

VARICOCELE OR FALSE RUPTURE--TWELVE YEARS' STANDING--CURED IN TEN DAYS.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

[Illustration: N.H. Sharitz, Esq.]

_Gentlemen_--Having been operated upon at the Invalids' Hotel and

Surgical Institute, Buffalo, N.Y., for the radical cure of a Varicocele

of the left side, from which I had suffered for twelve years, I take

pleasure in certifying to the speedy and certain relief afforded, and

the painless nature of the operation as performed by the surgeon of the

World's Dispensary Medical Association. Ten days from the time of the

operation, I returned home radically and permanently cured. I desire to

express my thanks to the medical staff for their skill and attention.

Gratefully yours,

N.H. SHARITZ,

Box 22. Rural Retreat, Wythae Co., Va.

VARICOCELE AND RESULTANT WEAKNESSES.

WASTING OF STRENGTH AND MANLY VIGOR--NOW STRONG AND WELL.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

[Illustration: Robert B. Wills, Esq.]

_Gentlemen_--I am unable to find words to express my feelings of

gratefulness and gratitude that I owe to your Institution, for the able

and gentlemanly treatment that I was favored with during my stay with

you, by officials and attendants in their respective capacities, in

every department. Nothing was left undone that could possibly be of

benefit to me or add to my comfort, and to your Institution, your

treatment, which in my own experience I have found to be marvelously

wonderful, I feel to-day as if I owe my health, my strength, my life;

for I firmly believe if it had not been for your timely and painless

treatment, instead of writing to you at this time, being in the

enjoyment of health and strength, I would be filling a place in an

insane asylum or an invalid's grave. And it may not be more than just to

your wonderful treatment to say that the Varicocele and resultant

weaknesses was of about fifteen years' standing, during which time I had

spent time and money with both physicians and quacks, without any result

for the better, and when my life blood was daily wasting away, and the

powers of manly strength and vigor were completely gone, by an act of

Providence I went to your Institution as a last resort, for life or

death. I was painlessly operated upon by you for my complaint, from

which time I have steadily improved in health, strength, weight and

vigor, until I have gone from 135 pounds, my weight when operated upon,

to 174, at which I tip the balance as I write to you to-day. If the

afflicted everywhere could only realize that so many lives may be spared

by your wonderful treatment, none would stay away.

You are at liberty to give my testimony to the world in whatever way it

may be of most benefit to you. I also enclose a photograph of myself

that has been taken since the effects of your treatment have been shown.

With feelings of much gratefulness, I am,

Very truly yours,

ROBERT B. WILLS,

No. 23 Elizabeth St., Hagerstown, Md.

RUPTURE OF SPERMATIC VEINS.

VARICOCELE (FALSE RUPTURE)--PREVIOUS OPERATOR LEFT PART OF SURGEON'S

NEEDLE IN FLESH; SUCCESSFULLY EXTRACTED AT INVALIDS' HOTEL.

[Illustration: Chas. P. Morse, Esq.]

"WHAT I THINK OF THE INVALIDS' HOTEL AND SURGICAL INSTITUTE:"

The Invalids' Hotel and Surgical Institute is an Institution first-class

in every respect, presided over by a capable, honest and pleasant lot of

medical experts who certainly know their business. I cannot speak of it

too highly.

I was treated there in the summer of 1887, for Rupture of the Spermatic

Veins, previous to which I had been operated on two different times,

with no relief, by a doctor here in this place cracked up to be one of

the best in Northern Illinois, and an officer of the Chicago Eye and Ear

Infirmary. The operation at the Invalids' Hotel was perfectly painless,

did not have to take any anæsthetic, neither was I confined to my bed at

all, and the result a perfect success; while in the two previous

operations I had here at home, I was confined to my bed a week each time

and another week scarcely able to move about, be sides getting worse

each time with pain enough to drive one crazy. But the half has not been

told. About two and a half years after I had been cured of my difficulty

at Buffalo, I commenced having terrible pains in my leg and abdomen, for

which I could not account, and after standing it until it seemed as

though I would be glad to die, I again consulted the Invalids' Hotel;

after a thorough investigation they operated on me where my pain seemed

the most apparent, and dug out a piece of a surgeon's needle something

over half an inch in length, that had been broken off in the first

operation I had by the doctor here at home, and so admitted by him when

confronted with it. I have spent lots of money and nearly six years of

the worst pain man ever stood getting relief, while had I known of this

place on the start, an operation with no pain whatever and scarcely more

discomfort than a sore mouth after having a tooth removed, would have

ended it all.

In conclusion, I will say to any poor sufferer, don't do as I did and

put your trust in the would-be greatest doctor you have at home, but go

to this place at Buffalo, where you will have proof of their ability,

and where you will surely meet patients about to leave, cured; others on

their way to recovery for the same difficulty you may have yourself, no

matter what it is, if curable at all; a place where you will have the

kindest of attention, the best of medical and surgical skill, and where

you can see sufferers going away every day with hearts full of gratitude

and happy.

Respectfully, CHAS. P. MORSE,

311 North Avon St., Rockford, Ills.

VARICOCELE-FALSE RUPTURE CAUSED BY INJURY.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

[Illustration: G.W. McCollom, Esq.]

_Gentlemen_--In the year 1866, sometime in July, I jumped from a load of

lumber to the ground, and at once felt a sharp severe pain along the

spermatic cord of left side of scrotum, preventing my walking to the

house without help. The veins near the cord filled to such extent that

they seemed solid, and could not be reduced for some time. I went to a

good doctor and by him was advised to "pay no attention to it, it will

not amount to much." From that time I suffered continually, and will not

try to describe what I endured until I was relieved by a surgical

operation performed on me by the surgeon-specialist of the Invalids'

Hotel and Surgical Institute, of Buffalo, N.Y. After working-hard for

several years my suffering increased and I was advised to consult Prof.

L., of Chicago Hahnemann College (of Homeopathic School) and by him was

informed an operation of tieing the veins (choking them off) could be

performed but 90 per cent (if I remember rightly) of the operations

proved fatal. I decided not to try it. By accident I learned of your

great skill, and though my case was of twenty-one years' time, and my

health and strength gone, I considered the method plausible and

reasonably safe. I had the operation performed, and now after six years

have passed, I can say with satisfaction, there is little to be noticed

or remind me of the past years of misery. The parts are of

healthy-color. Urine has assumed a natural appearance, both sides of

scrotum seem in size alike. No bandage is worn and for two years has

been discarded. My weight increased and for two years prior to the

taking of my photo, I did the work of handling a third-class post

office, doing a money order business of $50,000, not losing a day in

that time, and at the present time in this hot climate, I have been

doing outdoor work, some of it hard, and with mercury at 100 degrees. I

have worked and found no need of a bandage; and no unnatural relaxation

of the scrotum or veins is noticed.

If anyone wishes to write me, they are at liberty to do so. If my

experience can be of benefit to any, I will answer all enquiries, and in

a general way will now say no one should delay attending to such

difficulty, for if the blood is in a reasonably healthy condition your

surgeon will operate in such a way that the result will be all right in

time. I send photo taken in 1891.

Respectfully, GEORGE W. McCOLLOM,

Monrovia, Los Angeles Co., Cal.

VARICOCELE.

Sanborn, Barnes Co., N. Dak., Aug. 9th, 1895.

PROPRIETOR INVALIDS' HOTEL AND SURGICAL INSTITUTE, Buffalo, N.Y.:

_Dear Sir_--Having been afflicted with varicocele and loss of manhood

and having heard so much of the cure for these troubles at the Invalids'

Hotel. Buffalo. N.Y., I went there and was operated upon. The operation

itself is nothing to bear. It is painless and the result is a radical

cure. For this you have my sincere thanks. I take pleasure in

recommending your Institution to all sufferers and know that it is in

every respect just as claimed to be. I would say to all who suffer from

this trouble: go to the Invalids' Hotel and Surgical Institute, at

Buffalo, N.Y., and you will get relief. You will receive kind attention

from all.

Very truly yours,

George Bignall.

VARICOCELE AND GENERAL DEBILITY.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

[Illustration: J.L. Ridings, Esq.]

_Gentlemen_--I can bear testimony to the removal of varicocele, for

which you treated me. I had been in the habit of getting out with the

boys and trying to see which could kick the highest with one foot on the

ground, and it caused me to have varicocele. I went to my home doctor

and he treated me with no success. It was getting worse all the time and

I got out of shape all over. My health got bad and I thought my case

hopeless. I had tried two doctors and received no benefit.

I had one of your little Memorandum Books in my pocket, and one day,

looking through it I saw you treated such cases, and wrote you and

received word in a few days that you would treat me, so I sent off for

one month's treatment; and in five months I had gained my weight back,

and that was eight years ago and I feel sound and well and my health has

been good ever since.

You are at liberty to use my testimony in whatever way if may be of most

benefit to you.

I also enclose a photograph of myself that was taken soon after your

treatment.

With feelings of much gratefulness, I am,

Very truly yours,

J.L. RIDINGS,

Clarence, Shelby County, Missouri.

VARICOCELE AND NERVOUS DEBILITY.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

[Illustration: D.A. Walton, Esq.]

_Gentlemen_--I commenced treatment, I think, in July or August, of 1888,

and continued four months. My case was nervous debility of fifteen

years' standing.

I tried home doctors but found they were only aggravating my case. I

also tried the Remedy Company, then of St. Louis, who claimed to perform

wonderful cures with their "Pastiles," but they proved utterly

worthless. Having come in possession of Dr. Pierce's little book and

circulars, a perusal of the same convinced me that my health would not

be trifled with at his Institution.

I was a poor man and could not afford much experimenting. I ordered one

month's treatment, and at the end of this first month, I found, to my

surprise, that I was feeling different. The second month, still more

surprised at my returning health. Third month thought I was cured, and

engaged myself to a young lady, and wrote you to that effect, and you

advised me with your congratulations to marry, and to order another

month's treatment; and at the end of the fourth month I was a _man_,

something I did not know what it would be like to be before.

I have now been married five years, and have two healthy children--a boy

and a girl. I would never have dared to marry had it not been for your

medicines. I must add that during this treatment I was troubled with

varicocele on left side. I wrote you this at third month of treatment,

and you sent without extra charge, a Suspensory and Lotion, and two

months' treatment cured me sound and well of this distressing malady; I

have not felt the least symptoms of its return.

I want the world to know what a competent and honorable firm the World's

Dispensary Medical Association is. I would love to shake you by the

hand. May God let you continue to be a help to mankind is my prayer.

Yours truly,

D.A. WALTON,

Marion, Grant County, Ind.

BAD VARICOCELE OF LONG STANDING.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

[Illustration: J.M. Elam, Esq.]

_Gentlemen_--I feel many obligations to your noble skill, as physicians.

I was treated with much kindness by physicians and nurses. I was

surprised to find such a speedy cure of such a bad case of varicocele of

long standing; the operation was entirely painless and I felt a great

change in myself, as a result of it. Am so glad to tell any sufferer of

that terrible disease to apply to you at once and be cured, for I am

sure I could not have lived long as the pressure and burden was so great

_I could scarcely be on my feet at all_; any work in an upright position

was impossible.

Now it has been five years since I was operated upon and I feel well of

that disease--varicocele attended with impotency or weakness of the

generative organs, caused by varicocele.

Thanks to the good physician who relieved me--hope he may live long and

be able to relieve all that submit themselves to him for treatment, as I

did. I found everything that had been described to be just so in regard

to the Staff and Institution.

Gratefully yours, J.M. ELAM,

Flat Rock, Scott Co., Va.

DOUBLE VARICOCELE AND STRICTURE OF URETHRA.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

[Illustration: C. Hanson, Esq.]

_Gentlemen_--I have taken treatment from you for several months for

nervous debility, and although I am not quite fully cured as yet, I have

been greatly benefited, and believe, if I had come to you before I was

duped and swindled by different quacks and was more dead than alive, I

would to-day be a thoroughly well man.

I have also been to your Institute twice for surgical operations, and

cannot too highly praise the Hotel, or the skill and care of the

attending surgeons and nurses. They are gentlemen in every way and the

Invalids' Hotel is just as represented.

I shall advise all suffering from chronic diseases to go to you for

relief, as I have never seen any one there who was not cured or greatly

benefited.

Very truly yours,

CHRISTIAN HANSON,

Austin, Mower Co., Minn.

INDIGESTION, CONSTIPATION, VARICOCELE.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

[Illustration: Mr. Hodges.]

_Dear Sirs_--In regard to my condition of health, will say, although I

am not entirely well, yet I have received much and lasting good from

your treatment. My digestion was improved greatly, so that little

trouble is experienced after eating; my liver seems to act reasonably

well, and my bowels are much better. My varicocele I consider entirely

cured, as I have not used the bandage for one half day for more than six

months, and do not experience any inconvenience from that source.

Yours truly,

HARLAN HODGES,

Keota, Keokuk Co., Ia.

BAD VARICOCELE.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

[Illustration: W.H. Dellinger, Esq.]

_Gentlemen_--Having been operated upon at the Invalids' Hotel and

Surgical Institute for the radical cure of a bad varicocele, from which

I had suffered for eight years, I desire to express my thanks to you for

your kindness and skill. And I would advise all persons, needing

surgical or medical treatment, to go to the World's Dispensary Medical

Association.

Respectfully yours,

WILLIAM H. DELLINGER,

Vincennes, Knox Co., Ind.

VARICOCELE.

Cambridge, Furnas Co., Nebr.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--With great gratitude toward your most valuable Institute, I

feel indebted to you for the cure of varicocele. I was troubled ten

years with this annoying disease, caused, I think, by being thrown from

a horse. My case was of a very obstinate character. I was treated by a

leading specialist of Omaha, Nebr., without success and without being in

the least benefited. I expended the neat little sum of $500, and then

sank back in despair, losing all hopes of a cure. I had previous to my

treatment in Omaha noticed a little hand or Memorandum Book of the

World's Dispensary, and again one came to my notice. I mustered up

courage to write to you, and in June, 1892, I visited your Institute for

treatment. I was treated by the best skilled surgeons and given best

attention by experienced nurses. I met a number of patients while under

treatment troubled with various and complex diseases, who expressed

their gratitude to the Faculty of the Invalids' Hotel and Surgical

Institute. The operation performed was rendered painless, owing to local

applications previously applied. After the operation, which was about 11

o'clock, A.M., I rested until 12, noon, and responded to the dinner call

as usual. I was required to remain but ten days, then returned home, a

distance of some twelve hundred miles. I wore a neat fitting support for

about six months, and then abandoned it and have gone as nature created

me. Oh, what a relief. I had worn a "suspensory" for about six years. I

have had no return of former trouble, it being now about two years since

the operation.

To any suffering with varicocele I must say, "don't delay, but place

yourself under treatment at the Invalids' Hotel and Surgical Institute,

Buffalo, N.Y., and you will say as I do, 'The half has never been

told.'" With earnest wishes for your future success, I am,

Yours truly,

E.L. Brown

VARICOCELE.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

[Illustration: D.E. Righetti, Esq.]

_Gentlemen_--I wish to inform you of the success of your treatment of me

for varicocele on the left side and its attendant weakness, etc. I am

now happy to say that through the agency of your surgical skill and the

efficacy of your medicine, I am healthy, strong, and a perfect man. I

suffered for about two years previous to the operation with acute pain

in the parts, and continued mental anxiety. I desire to express my

entire satisfaction that, during the ten days that I remained in the

Invalids' Hotel, I never experienced such uniform kindness and attention

as I did from the attending surgeon and from all the attachees, and that

I recommend all persons similarly afflicted to consult you, and they can

be sure to find the way to happiness.

Respectfully yours,

D.E. RIGHETTI,

Cayucos, San Luis Obispo Co., Cal.

VARICOCELE

OF TWENTY YEARS' STANDING--CURED "WITHOUT PAIN.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

[Illustration: C.H. Boyle, Esq.]

_Gentlemen_--I take great pleasure in recommending the Invalids' Hotel

and Surgical Institute. After trying my home physicians without

obtaining any permanent relief, and growing constantly worse, I went to

this famous Institution and submitted to an operation for varicocele.

This was a perfect success, and soon I felt like a new man, and as

strong as I ever did. I feel that nothing I could say would do justice

to this renowned Institution. In every way, it is kept in advance of the

age. The staff of physicians and nurses spare no pains to make the visit

of every one pleasant as well as beneficial in the highest degree. I

would urge all sufferers afflicted as I was, or with any chronic

disease, to avail themselves, without delay, of the skillful treatment

to be obtained of the specialists of the World's Dispensary Medical

Association, for I am confident that they will receive all the benefit

that can be obtained from medical or surgical treatment and care.

Yours truly,

CHAS. H. BOYLE,

Fort Benton, Choteau Co., Montana.

VARICOCELE.

SPENT $500 WITH OTHER DOCTORS TO NO PURPOSE.

Bryson, Jack Co., Texas.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--I had been troubled with varicocele for nine years, and had

given up ever being cured. After spending $500.00, with medical quacks I

then went to the World's Dispensary Medical Association as a last

resort. One of their skillful surgeons performed an operation upon me

which was entirely painless. I conversed with several other patients,

who had the same disease. They seemed happy to know that there was such

an Institution that could relieve suffering humanity. The surgeons and

nurses were so good and kind to us and gave us the best of attention and

even the patients had a very fraternal feeling toward each other.

Your Institution is finely equipped and has the best of accommodations.

Accept my thanks.

Yours truly,

A.D. Bryson

A BAD CASE.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, 663 Main St., Buffalo, N.Y.:

[Illustration: H.C. Decker, Esq.]

_Gentlemen_--I have been cured of an almost life-long difficulty by the

skill of your specialist, and heartily thank you for the successful

manner in which the operation was performed in my case. The result is

complete and perfect relief, and as time advances I can each day more

fully appreciate the value of your Institution. The time spent there I

shall never forget, as it was a time of extreme pleasure to me. The

operation was _perfectly painless_ and did not confine me to my bed, and

this taken with the extreme kindness of every one connected with the

Institution, made the time pass in a very happy manner.

I consider your Hotel first-class in every respect, and would heartily

advise all sufferers from chronic ailments to visit you before giving up

their cases as hopeless.

Respectfully yours,

H.C. DECKER,

Dresbach, Winona Co., Minn.

VARICOCELE-CAUSED FROM STRAIN.

Montague, Sussex Co., N.J.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--In reply to your inquiry concerning my treatment, I

cheerfully give you the following testimonial: "I was troubled for many

years with a very bad varicocele, which I received when a boy while

jumping. The complaint troubled me exceedingly. I tried almost every

known means to effect a cure, but with no avail, for the more I doctored

the more aggravated became the disease. After thus suffering for many

years and knowing of the fame your Institution had attained in curing

such diseases, I at last consulted your specialist in that class of

diseases--was operated upon and returned home in ten days, a sound and

well man. I can recommend your Institution to all suffering humanity as

the most home-like, your nurses the most attentive and specialists the

most skillful the world can offer. May you long be the benefactors of

mankind."

Yours truly,

F.L. Van Etten

VARICOCELE.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

[Illustration: E.H. MAHNKEN, ESQ.]

_Gentlemen_--The result of your operation, performed one year and a half

ago for a case of varicocele of twelve years' standing, and which had

troubled me very much, has cured me entirely. I am thankful to God that

He put it into my mind to visit your Surgical Institute. I cannot

recommend your skill too highly.

Yours truly,

ED. H. MAHNKEN,

Smithton, Pettis Co., Mo.

VARICOCELE.

Medora, Billings Co., N. Dak.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Gentlemen_--Having been operated upon at the Invalids' Hotel and

Surgical Institute, Buffalo, N.Y., for the radical cure of a varicocele

on the left side from which I suffered four years, I take pleasure in

certifying to the speedy and certain relief afforded, and the painless

operation, as performed by the surgeon of the World's Dispensary Medical

Association. Ten days from the time of the operation I returned home

permanently cured.

I desire to express my thanks to the Medical Staff for their skill and

attention.

Gratefully yours,

Geo. O. Reid

A STRONG ENDORSEMENT.

_To whom it may concern_:

[Illustration: H.E. Bankston]

This is to certify that I took treatment at the Invalids' Hotel and

Surgical Institute, Buffalo, N.Y., and I was cured of a chronic trouble

that had been maltreated by other physicians. While there I saw a man

who had been cured by the specialists, who had before been given up to

die by the best doctors in Troy, N.Y. Of course, the case must have been

a very stubborn one. I afterwards saw a man here, in Georgia, die, who,

if he had been in Pierce's Surgical Institute under the treatment and

care of his skilled doctors and nurses, I know would have most assuredly

got well. Why? Because it was only a cage of _stone in the bladder_, and

they are easily cured at Dr. Pierce's Surgical Institute. I think almost

any chronic disease can be cured there, if taken in time, judging from

my observations while an inmate of that Institution.

H.E. BANKSTON,

Barnesville, Pike Co., Ga.

* * * * *

HYDROCELE,

OR DROPSY OF THE SCROTUM.

This malady consists of a collection of water in the _tunica vaginalis_,

or membranous sac which contains the testicles. It may affect either one

or both sides. In health the sac-like covering, or investing membrane,

of the testicle secretes a limpid fluid which lubricates its inner

surface. When secreted in excess, it accumulates and constitutes

_hydrocele_.

The tumor commences at the bottom of the scrotum and grows very

gradually, while hernia, or rupture, with which it is often confounded,

progresses from above downwards and makes its appearance suddenly.

We were recently consulted by an aged gentlemen, whose disease a

distinguished surgeon had pronounced _double hernia_. On examining the

enlargement, we found the disease to be dropsy of the scrotum,

complicated with varicocele.

CAUSES. Injuries from blows or bruises are among the most common causes

of this disease. It may also result from inflammation of the testicle or

from excited action in those parts. It has been known to result from

stricture of the urethra, or water-passage, and also from local

irritation along that passage.

HYDROCELE.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

[Illustration: H.H. Williams, Esq.]

_Dear Sirs_--In answer to inquiries will say, that any person afflicted

as I was, I would advise them not to listen to any ordinary doctor, but

leave at once for the Invalids' Hotel and Surgical Institute, Buffalo,

N.Y., where he could get the best of treatment and attendance that money

could procure. The table also is loaded with the best of fruits,

vegetables, and the finest meats of the markets.

Respectfully,

H.H. WILLIAMS,

St. Augustine, Florida.

HYDROCELE.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

[Illustration: D. Flynn, Esq.]

_Gentlemen_--Without solicitation, but simply to aid suffering humanity,

I take pleasure in recommending your place to any suffering from

Hydrocele.

I was cured in a short time, after having the Hydrocele for eighteen

years. Your new process is painless, no knife being used and is certain,

sure and safe. With many good wishes of success, I am,

Yours truly, DAVID FLYNN,

(Engineer, S.F. & W. Ry.,)

Way Cross, Ware Co., Ga.

HEMATOCELE OR RUPTURED VEINS.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

[Illustration: D. Parker, Esq.]

_Gentlemen_--I was afflicted with Hematocele of large size, caused by an

injury, for which home-treatment gave me no relief.

Hearing of your Invalids' Hotel I went there and had an operation

performed for its cure. I have the greatest confidence in your

Specialists, as the operation was a perfect success. It was perfectly

painless, and I was able to go home in less than two weeks with the cure

complete. I take pleasure in certifying to the good work you are doing.

With the best of feeling toward the Invalids' Hotel, I am,

Yours truly,

DON PARKER,

P.O. Box 155, Oakfield, Genesee Co., N.T.

HYDROCELE WITH VARICOCELE.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

[Illustration: D. Huntington, Esq.]

_Gentlemen_--About five years ago, having been a patient at, the

Invalids' Hotel and Surgical Institute and undergone a painless

operation for the cure of hydrocele and varicocele--which was performed

to my entire satisfaction. I desire to express my thanks to the Medical

Stuff for their skillful treatment of my case. Two weeks from the time

of the operation I returned home, radically and permanently cured.

I recommend all similarly afflicted to consult the World's Dispensary

Medical Association.

Yours truly,

DANIEL HUNTINGTON,

Huron, Beadle Co., So. Dak.

TWENTY-TWO YEARS' STANDING--UNSUCCESSFULLY TREATED BY OTHERS.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

[Illustration: E.L. Waters, Esq.]

_Gentlemen_--I wish to acknowledge that you have cured me of the worst

case that ever came within my knowledge, it having afflicted me

twenty-two years. After I had suffered much from other surgeons without

any cure being effected, and with only relief for a short time, you

performed a not only painless but very scientific operation, and with

medicine completed the cure. It is now five years since you treated me

and no symptoms of the disease have shown themselves. I will also add

that while with you at the Invalids' Hotel I received the best of care

and attention from the well trained nurses in your employ, for all of

which I feel grateful.

With respect and best wishes,

EDWIN L. WATERS,

Athol Centre, Mass.

* * * * *

THE URINARY ORGANS:

THEIR ANATOMY, PHYSIOLOGY AND PATHOLOGY.

By reference to Fig. 1 the reader will get a good understanding of the

relative positions of the kidneys, bladder, and adjacent organs.

THE KIDNEYS.

It is hardly necessary to discuss the minute structure of these organs

in a book intended for the non-professional reader.

The function of the kidneys is to remove certain waste materials from

the blood. As fast as excreted by the kidneys, the urine passes through

the ureters, of which there are two,--one leading from each kidney, into

the bladder. The ureters are lined with a continuation of the mucous

membrane, reflected from the bladder upwards, and this lining also

extends to the cavities of the kidneys.

Calculi or gravel, and stones, forming, as they sometimes do, in the

kidneys, and passing down through these delicate and sensitive canals,

cause excruciating pain. The symptoms of renal calculi passing from a

kidney to the bladder are, as already indicated, severe cutting pain in

the loins, and along the ureter, attended with considerable fever. A

very rough stone, such, for instance, as a mulberry calculus, passes

with considerable difficulty, and the patient is often suddenly seized

with excruciating agony in the loins and in the groin, the pain also

shooting down into the testicle of the corresponding side, often causing

it to retract. There is usually, also, sympathetic pain shooting down

the thigh. We have seen patients roll on the floor in the greatest

agony, cold sweat meanwhile pouring down their faces, when thus

suffering. The patient may also vomit violently, through nervous

sympathy. The urine is apt to be bloody, and there is a constant desire

to pass it. There is pain in the end of the penis, and also in the lower

portion of the abdomen.

THE BLADDER.

This is a sac, or reservoir, to receive and hold the urine as it comes

from the kidneys through the ureters. Its walls are partly composed of

muscle, and partly of a lining mucous membrane. The muscular coating is

external, and it is by its contraction that the urine is expelled. When

empty, the bladder shrinks down to a small size, as compared with its

distended condition. When filled, it is capable of holding about one

pint. If it is distended by the retention of urine much beyond this

capacity, the muscular coats lose their force, and often the urine

cannot be passed naturally. In health, when the bladder becomes filled

and distended, there is a consequent desire to empty it by passing

water.

[Illustration: Fig. 1.]

The voiding of the urine should not be attended with the slightest pain

or disagreeable sensations, and the desire to pass it should not be

frequent. When there is frequent desire to pass it, or when its passage

is attended with pain, there is irritation, or inflammation, in the

coats of the bladder, or in the urethra. This may arise from an

excessively acid or irritating condition of the urine, as well as from

various other causes. Gonorrhea, or clap; stricture of the urethra,

which impedes the free flow of the urine; enlargement or inflammation of

the prostate gland; gravel, and stone in the bladder, are all capable of

creating a frequent desire to pass water. Whatever the unhealthy

condition may be which gives rise to this troublesome symptom, it calls

for prompt and skillful treatment, for the most trivial affections of

these organs often pass into those that are exceedingly intractable, if

not incurable.

THE EXAMINATION OF THE URINE. The urine itself, when subjected to

microscopical or chemical examination, as we shall hereafter more fully

explain, offers the best means of determining the exact nature of these

distressing affections. When normal, the urine is of a pale straw-color,

and throws down no deposits on cooling. In passing it no difficulty or

pain should be experienced, and it should spurt from the urethra in a

full, round, and regular stream, until the bladder is entirely emptied.

If the stream is forked, checked, or interrupted in any way before the

bladder is completely emptied, it is evidence that something is wrong.

Stricture of the urethra, prostatic disease, and gravel, or stone in the

bladder, are all capable of producing obstruction to the free flow of

the urine.

HOW SLIGHT AILMENTS BECOME DANGEROUS DISEASES. As we have before stated,

the mucous membrane lining the bladder is reflected upwards into the

ureters, lining these canals. By reason of this continuity of mucous

surfaces, patients suffering from urethral, prostatic, and bladder

affections, often die from disease of the kidneys. It must not be

supposed that because stricture of the urethra does not co-exist with

_Brights_ disease, that the latter may not have been caused by the

obstruction in the urethra due to stricture. Pulmonary consumption, for

instance, often begins in the form of nasal catarrh, but, by the

continuity of the mucous membrane, it travels, so to speak, into the

throat, or pharnyx; from the pharnyx into the larnyx, and then into the

lung structure itself. The disease is transferred from the nose into the

lung tissue. What occurs in the nasal, laryngeal, and pulmonary tract of

mucous membrane, happens, also, in the urinary tract. A gonorrhea, which

is a specific acute inflammation of the urethral canal, leaves behind it

a slight gleet, or chronic inflammation of the mucous membrane of the

urethra. This may give little inconvenience for a number of years, but

gradually it culminates in a stricture, or, implicating the prostatic

portion of the urethra, occasions inflammation of the prostate gland,

and, perhaps, enlargement of this organ. This gradually gives rise to

cystitis, or inflammation of the bladder. From the bladder, the disease

travels up the ureters into the kidneys, and finally _Brights_ disease

is established in these organs.

The mucous membrane lining the bladder also extends through the urethra.

Throughout the interior of the body, whether it be in the stomach,

lungs, or other parts, this lining mucous membrane serves as a

protection to the parts beneath, just as the skin on the exterior of the

body serves as a protection to the sensitive true skin and the tissues

underneath it.

THE CAUSE OF CERTAIN DISTRESSING SYMPTOMS. Close to the neck of the

bladder is a triangular space, on which the mucous membrane is smoother,

and devoid of folds, or rugae, and which is far more sensitive and

vascular than other portions of the mucous membrane lining this organ.

It is called the _trigone vesical_. This _trigone_ is the most depending

part of the bladder. If there be stone in the bladder, it naturally

gravitates and rests on this sensitive space, so that, when the bladder

is empty, the foreign body occasions inconvenience, until the urine,

trickling down through the ureters, and intervening between the mucous

membrane and the stone, serves as a temporary protection to the mucous

surface. Hence the pain becomes less as the urine is secreted, until the

water is again passed, and the intervening fluid thereby removed, when

the stone again presses upon, and irritates, the sensitive _trigone_, by

coming into more immediate contact with it. The greater ease with

patients afflicted with stone experience in a recumbent position in bed,

or on a sofa, compared with being in an erect posture, is easily

explained. The foreign body, when the patient is standing, walking, or

riding, falls by its own gravity on this sensitive spot; when in a

recumbent position, it rolls away from this sensitive _trigone_ into the

back part of the bladder, where the mucous membrane is less sensitive;

consequently, the patient suffering from stone in the bladder is more

easy at night, whereas, one suffering from prostatic disease, whether it

be inflammation of the prostate gland, or enlargement of that organ, is

usually worse in bed.

HOW BLADDER DISEASES COME TO BE CONFOUNDED WITH OTHER DISEASES. The

bladder is largely supplied with blood-vessels, lymphatics, and nerves,

given off from the same systems that supply the rectum or lower bowel,

and in females the uterus or womb, and the ovaries. This accounts, in a

great measure, for the symptoms of bladder disease in those afflicted

with piles, or other diseases of the lower bowel, or of diseases of the

uterus or womb in the female. We have frequently been consulted by

patients who had erroneously supposed themselves to be suffering from

disease of the bladder, or of the prostate gland, but whom we found, on

examination, to be suffering from hemorrhoids, or piles. In these cases,

by removal of the pile tumors, the frequent desire to urinate, and all

pain in the region of the bladder, are promptly relieved. Sometimes,

ulcers located in the rectum, give very little unpleasant sensation in

the bowel, but produce pain in the bladder, with frequent desire to

urinate. Enlargement of the uterus, the womb, or displacements of that

organ, as prolapsus, or anteversion, and all capable of producing

symptoms of bladder disease. A frequent desire to urinate and more or

less sharp pain in the region of the bladder are usually experienced in

these cases. Disease of the bladder, in like manner, often produces an

apparent disease of other organs through sympathy, and without great

care in diagnosticating each case, the _effect_ may be taken for the

_cause_, and the patient treated for a disease which does not really

exist.

THE URETHRA.

The urethra, in the male, is the canal extending from the bladder to the

end of the penis, through which the urine is passed. This canal starts

from the base of the bladder, passes through the prostate gland, and,

entering the penis, continues of about uniform size along the under part

of the penis until it reaches the glans, or head of that organ, where it

expands somewhat into a bulb-like fossa, or cavity, and becomes reduced

again at the orifice. At a short distance from the bladder it receives

the outlets of the seminal ducts. The urethra is a most delicate and

sensitive canal, and is surrounded by tissues of like delicacy, and is

lined with a mucous membrane which is highly vascular, and filled with

sensitive nerves. The introduction of any instrument into this canal is

to be undertaken only when absolutely required, and when necessary. It

should be so skillfully and carefully effected that no pain or

irritation can result. The slightest awkwardness is liable to cause an

unnoticeable injury, which may result in a false passage, or an effusion

of plastic lymph around the canal, which, organizing, forms the most

troublesome kind of organic structure. By proper and early treatment all

danger and pain is avoided, and a cure effected in a very short time. In

an extensive practice, in which we yearly treat thousands of cases, we

have never yet failed to give perfect and permanent relief from

stricture, or disease of the prostrate gland, without the necessity of

using cutting instruments of any kind, when we have been consulted

before injury to the urethra has been produced by the improper use of

instruments. Having specialists who devote their entire time and

attention to the study of these diseases, we are able to relieve and

cure a large number painlessly and speedily, in which the awkward

manipulations of physicians or surgeons, whose hands, untrained by

constant and skillful use, not only fail to effect any benefit, but set

up new, or aggravate existing, disease.

This subject will receive a more full and complete consideration in

another part of this treatise.

THE PROSTATE GLAND.

The prostate is a gland of about the size and shape of a large chestnut,

lying just in front of the bladder, and surrounding the urethra. The

size of the prostate gland varies considerably with the age of the

person. In early life it weighs but a few grains. As puberty approaches

it becomes larger, and in the adult weighs from half an ounce to an

ounce. In old age it enlarges considerably, and sometimes presses upon

the bladder so as to impede the flow of urine. This condition is often

confounded with stricture, gravel, or stone in the bladder, by

inexperienced physicians. Hypertrophy, or enlargement of the prostate

gland, is not an unfrequent disease in the adult or middle-aged man.

Being in close contact with the bladder, when it enlarges it encroaches

on the bladder, pressing on it, and it has the effect of interfering

with the function of urination. As before indicated, enlargement or

hypertrophy of the prostate gland, is often confounded with stricture,

gravel, and stone in the bladder, by inexperienced physicians, and

treated accordingly. The true condition of this gland is readily

determined by an examination through the rectum or lower bowel, the

finger of the expert surgeon being able to determine at once whether it

is enlarged or not.

THE DANGER OF BAD TREATMENT. In disease of the prostate gland, as well

as in inflammation of the kidneys and bladder, stricture of the urethra,

and many other forms of urinary disease, the use of stimulating

diuretics, and the much-advertised "kidney cures," "buchus," and similar

preparations, which largely increase the flow of urine, simply

aggravate, and do positive harm. In fact, the most difficult cases that

we have had to deal with have been those that, through such treatment,

either taken on their own account or prescribed by inexperienced

physicians, have been rendered so much worse as to make their cases very

intractable, and tedious to relieve and cure.

REQUIRE NICELY ADAPTED TREATMENT. As we have heretofore indicated, there

is no class of diseases that require nicer adaptation of medicines to

each individual case, than those of the urinary organs. Medicines which,

in one stage of these diseases are beneficial and curative, in another

stage are often exceedingly injurious. Hence it is that we claim it to

be impossible for any one to put up any set prescription, or proprietary

medicine, that will meet the wants of a large percentage of this class

of cases. The only rational course to be pursued is to examine carefully

each case as it is presented; find out the exact condition and stage of

the disease with which the patient is afflicted, and then prescribe for

it such special medicines as are nicely and exactly adapted to the

patient's condition. These, in many cases, will have to be changed from

time to time, to suit the ever-changing condition of the disease, as it

is modified by the treatment. Not only have the manufacturers of

"buchus," "kidney cures," etc., committed grave errors by prescribing

stimulating diuretics for almost all kidney and bladder diseases, under

the impression that, as the patient passes only a small quantity of

urine at a time, the kidneys should be stimulated to secrete more, but

physicians in general practice have been very prone to commit the same

error in their practices. When the bladder and kidneys are in a weak and

diseased condition, incapable of efficient action, the bladder being

already unable to dispose of the diminished quantity of urine secreted,

it is simply outrageous practice to administer medicines calculated to

stimulate the kidneys to perform more work. By being thus forced, these

organs become seriously diseased. It would appear most unreasonable to

whip and spur a horse already jaded from overwork. Common sense would

dictate rest, which always does good; but, as the bladder is weak, the

doctor whips up the kidneys with drugs, thus endeavoring to force them

to secrete more urine, and thereby the poor, crippled bladder, which is

incapable of disposing of even the diminished quantity secreted, is

actually made to do more work in a diseased and feeble condition, than

it would perform in a sound, strong, and healthy state. The results of

this pernicious practice are _Bright's_ disease of the kidneys, cystitis

or inflammation of the bladder, and numerous other grave maladies.

* * * * *

KIDNEY DISEASE.

Diseases of the kidneys are generally very slow in their inception,

coming on gradually and manifesting no special symptoms of their

presence until they have assumed a formidable character. For this reason

they are the more dangerous. Simple derangement of the urinary secretion

is no evidence of disease of these organs, as changes in the color,

quantity and specific gravity of the urine are often produced by changes

of temperature, active or sedentary habits, mental emotion, and

sometimes by articles of diet, or drink, as well as by the use of

different drugs.

The existence of disease of the kidneys in the early stages can only be

positively determined by a microscopical and chemical examination of the

urine, which reveals to us the presence of casts, epithelia, blood, pus,

etc. The microscope informs us not only of the presence of disease, but

very often of the particular portion of the kidney in which it is

located, as well as of the stage which the disease has reached. We are

also aided by chemistry in determining the exact abnormal condition of

the kidneys by the detection of albumen, sugar, etc. These examinations,

by aid of the microscope and chemical re-agents, should never be

neglected by the physician. Without them his diagnosis, or judgment of

the patient's condition, is simply guess-work. With them he is enabled

to base his treatment upon certain and positive knowledge of the

patient's real and true condition.

The usual symptoms of chronic disease of the kidneys, but which vary

materially with the age, constitutional peculiarities and temperament,

are weakness in the small of the back, pains in the region of the loins

and groins, numbness of the thigh on the side of the affected kidney

(for often only one organ is affected), high-colored and often scalding

urine, many times depositing a sediment, sometimes white or milky urine,

bloody urine, frequent desire to pass the urine, partial impotency,

pains in the testicles and shooting into the loins, suppression or

inability to pass the urine, gravel, stone in the bladder, dropsical

swellings, swelling of the testicles, irritability and pain in the

bladder, mucous and sometimes seminal discharges oozing from the

urethra.

WHEN THE BLADDER IS AFFECTED the prominent symptoms usually complained

of are irritability of the bladder, accompanied by a frequent desire to

urinate, inability to retain more than a small quantity of urine, and

this for a short time only, pain in the region of the bladder, extending

into the back, thighs, etc., hot scalding sensations in passing the

urine, sediment in the urine, and sometimes bloody urine. The appetite

is usually diminished, there is a depression of spirits, the urine is

often passed only by drops, and is irregular in quantity and quality,

frequent inability to pass the urine at all, in males partial impotency,

with dull disagreeable pain in the testicles and irritation of the

urethra, attended with mucous and sometimes seminal discharges oozing

from the urethra. Some of these symptoms may be present as the result of

functional or organic disease of other organs than the kidneys or

bladder, and to distinguish them with positive certainty is impossible

without the aid of a microscopical and chemical examination of the

urine.

* * * * *

BRIGHT'S DISEASE.

This affection may appear in either an acute or chronic form. The acute

form is frequently a complication, or sequel of scarlet fever,

diphtheria, cholera, typhoid fever, erysipelas or measles, and is

frequently developed by intemperance. The acute form of the disease is

very rapid in its progress, often destroying life by uraemic

poisoning--the retention of urea in the system.

The symptoms of the acute form are diminution or suppression of urine,

dry skin, chills, thirst, pains in the loins, and a general dropsical,

puffy condition of the system, especially manifesting itself in the

earlier stages under the eyes, but gradually showing itself in the

oedema, or swelling of the feet, and lower extremities generally. Unless

promptly relieved, the patient dies of coma (stupor), or from

convulsions. No person should be so rash as to attempt the treatment of

this dangerous affection without the aid of the best medical skill that

can be procured.

IT IS THE CHRONIC FORM OF BRIGHT'S DISEASE that we propose principally

to discuss in this article. True Bright's disease of the kidneys is an

insidious and most fatal form of organic disease.

We venture to assert that less than one per cent. of those who imagine

they have "Bright's," have this disease at all. We find that most of

those who, as one of our Faculty puts it, _insist upon having_ Bright's

disease, base their "diagnosis" upon the ever-changing condition of the

urinary secretion, and especially upon the copiousness of the deposit;

whereas, in true Bright's, deposits of any kind are rarely met with.

Perhaps the form of deposit most commonly mistaken for Bright's disease,

is that known to medical men as the _urates_. When the urates are in

excess they form a heavy pinkish deposit of a flocculent nature within

from five to thirty minutes after the urine has been passed--that is,

after it has been passed sufficiently long to cool. To prove that the

deposit is urates, heat the specimen to the temperature of the blood,

when the deposit in question will disappear. Excess of urates has now

been definitely traced, in the majority of instances, to functional

torpidity of the liver.

Another common form of deposit is that in which the reaction of the

urine, instead of being acid, as in health, is either neutral or

alkaline, and in which the earthy phosphates are precipitated for this

reason. The earthy phosphates, when thrown down by a neutral or an

alkaline condition of the urine, appear as a heavy white deposit, which,

though usually devoid of clinical significance, is certainly calculated

to frighten timid patients who read of the "terrible ravages of

Bright's" in the advertisements of various popular "kidney cures." To

prove that the precipitate is phosphatic in its nature, add a few drops

of vinegar and it will disappear; whilst, if, after the vinegar has been

added, the specimen be brought to the boiling point, not only both the

urates and phosphates remain in solution, but there is only one single

substance known to pathological chemistry that can form a deposit under

these conditions--and that substance is albumen, which, if present in

quantity, is always indicative of serious disease.

The papers are filled with the plausible but unwarranted statements of

the manufacturers of various "kidney cures," who anxiously desire that

every one should be impressed with the idea that all their troubles

arise from kidney disease in order to sell large quantities of their

medicines. In many cases the unfortunate patient is rendered much worse

by the use of remedies that are not suited to his condition, and which

will not cure the real trouble with which he is affected.

Daily we are consulted by persons in whose cases these errors have been

made. In reality, true Bright's disease is not a common affection, and

nine out often individuals who think that they suffer from it, or the

early stages of the trouble, in fact have something more curable. In

some cases it is an affection of the liver, which forces an excretion of

unnatural salts by the kidneys, and thus renders the urine acrid and

irritating, or they may be suffering from some other disease, such as a

deformity or enlargement of certain glands, as the prostate; unnatural

position of the organs, as with women who suffer from weakness, the

uterus pressing forward on the bladder and urethra, and thus showing

every evidence of disease in the urinary canal. It is as common for

persons to suffer from deformity of the urinary canal as from misshapen

limbs, or from noses and ears not of proper size and proportion.

The urinary canal, from the bladder outward, is narrow and delicate. Any

disease or injury therein is liable to result in gradual contraction,

which may be manifested long years after the cause has been forgotten,

or has disappeared. These affections, to the inexperienced, or the

physician who is not particularly alert and cautious in his diagnosis,

are liable to cause error, and he will pronounce a given case Bright's

disease, when in reality there is some simple cause for the irritation

of the urinary canal, and the pains in the kidneys, etc., all of which

frequently result from a slight damming up of the flow of water, and the

prevention of free expulsion from the system of the salts of which the

body is relieved by the kidneys. They cannot work under pressure. When,

from any cause, the flow of water is checked, and, as it were, dammed up

so that a slight pressure is put upon the kidneys below, their secretion

is most materially interfered with, and the many trains of symptoms that

usher in disease of the kidneys, appear.

The true, and only sure way to relieve these conditions, as can be

understood by any one, is to remove the real cause. The use of any

medicine that stimulates the kidneys to an irritable action, under such

pressure, is to be avoided, as it only makes the trouble worse,

increases the amount of water that is dammed up, and results in more

serious manifestations of constitutional disease; whereas, by merely

relieving the choked outlet, the flow of water becomes free, and the

kidneys are speedily restored to their natural condition. This is well

illustrated by the following:

Case 113,396.

As recorded at the Invalids' Hotel. L.C.K., farmer, age 41,

married. For a period of nearly ten years, as a result of

slight injury, he had suffered from cloudy and

unhealthy-looking water, with some burning on passing it;

frequent calls to urinate; swelling of the limbs, loss of

energy and strength; headache, etc.; gradually there appeared

severe pain in the back, at times recurring with a sense of

fullness in the abdomen. For a period of nearly eight years he

had been constantly treated by physicians at his home, all of

whom had investigated his case. He had made several long

journeys to consult the manufacturers of a much-advertised

"kidney cure," who, after pretending to examine his urine,

scientifically (none of the proprietors are physicians),

assured him that, without the shadow of a doubt, his disease

was Bright's, and that he might be cured by their "kidney

cure," which was for sale at all drug stores. For a period of

eighteen months he steadily took this "cure," which, he states,

he is sure aggravated his disease, as, although his sufferings

at times were less, he felt that he was not improving in the

least, and that his disorder was not being properly controlled.

His home physician went with him on several occasions,

consulted with the owner of the proprietary medicine, and was

equally mistaken in his diagnosis. After consulting many

doctors, all of whom assured him they could give him treatment

that would prolong his life somewhat, and make his condition

comfortable, but that no treatment would affect his cure, he

was induced, by reading our article, heretofore referred to, to

consult us. A very thorough examination of the case was made,

which resulted in finding two contractions of the urethra,

which admitted only the smallest sized probe, and which,

necessarily, prevented the free flow of the urine. These were

speedily removed, when, much to the surprise of his family

physician, who accompanied him, over thirty-seven ounces of

fluid were drawn from the bladder. This gave him immediate and

perfect relief. The pains and aches in the region of the

kidneys, the weakness and tenderness, and the many other

uncomfortable symptoms with which he was troubled, all

disappeared. From a feeble and irritable invalid, in a few

weeks he was converted into a happy and cheerful man. The

symptoms of congestion and irritability of the kidneys

gradually disappeared, and in thirty days after visiting us he

writes that he feels himself entirely sound and well. This

gentleman states that he will be pleased to correspond with any

one who wishes to learn the particulars of his case, and his

full name and address will be furnished to any inquirer.

Bright's disease when fully established is characterized by degeneration

of the kidneys. Submitted to examination, after death by this disease,

these organs present various appearances. Hence, the degeneration that

characterizes the disease has been designated as waxy degeneration. Some

pathologists contend that the disease consists of several different

renal maladies, all of which, however, agree in the one ever-present

symptom of a more or less albuminous condition of the urine.

As to the causes of kidney disease, it may be said that any thing which

will give rise to a greater or less degree of congestion of the kidney

will induce either a temporary albuminous condition of the urine, or a

true Bright's disease of the kidneys. Suppression of perspiration, by

exposure to cold and wet, want of cleanliness, deficiency of nutritious

diet, liver disease, certain poisons in the system, as of scarlet fever,

measles, erysipelas or diphtheria, taken in conjunction with sedentary

habits, bad air, excessive mental labor or worry, may each occasion an

albuminous urine, and finally result in Bright's disease, but of all

causes that appear to produce this disease, none are so prolific as

intemperance. A scrofulous diathesis, or habit of body, may strongly

predispose to the disease, and chronic kidney disease frequently follows

acute rheumatism and the practice of masturbation. In some instances the

chronic form of Bright's disease follows an acute attack, but is more

often developed slowly and insidiously without any known cause.

THE SYMPTOMS of this fatal malady generally appear so gradually that

they excite but little or no concern until it has reached its more

advanced and dangerous stages. Frequently, a puffy, watery or flabby

condition of the face, particularly under the eyes, is the first symptom

noticed, and the patient may observe that his urine is diminished in

quantity. The urine is sometimes abundant, but generally more scanty

than in health, is acid in its reaction, and generally of a low specific

gravity. The countenance is generally somewhat pale and bloodless,

which, taken with the dropsical condition of the system, and the

constant albuminous condition of the urine, points the expert specialist

to Bright's disease of the kidneys. Various circumstances and conditions

may give rise to the temporary presence of albumen in the urine, and,

although albumen may be temporarily absent from the urine even when

Bright's disease exists, yet this is not common. There are certain

indirect symptoms which point clearly and almost unmistakably to the

presence of this disease. These are deep-seated pain or weakness in the

back, gradual loss of flesh, red, brown, or dingy urine, more or less

drowsiness, and as the disease advances, a smothering sensation, or

difficulty in breathing, with dropsical puffiness or swelling.

Occasional attacks of nausea and vomiting are common; pains in the limbs

and loins, which are often mistaken for rheumatism. Irregularity of the

bowels is also common. The skin becomes harsh and dry, not perspiring

even under active exercise. Sometimes these symptoms are years in their

development, being very obscure at first, and in some cases the disease

has been known to prove fatal without the patient having experienced any

extraordinary symptoms. With those whose systems are enfeebled by want,

intemperance, exposures or disease, as scrofula or syphilis, the first

symptoms usually observed will be a frequent desire to urinate,

occasional attacks of diarrhea, flatulency, dropsical swelling of the

face, especially under the eyes, and afterwards of the extremities,

paleness and increasing debility. Stupor, apoplexy and convulsions are

the forerunners of a fatal termination.

Microscopical and chemical examinations of the urine are the only

reliable means of diagnosis, and should be often repeated. (See Urinary

Signs, in Appendix.) As albumen is often present in the urine without

the existence of Bright's disease, it is impossible, except by the aid

of the microscope, to distinguish true Bright's from other affections of

the kidneys. In both purulent urine, and that containing blood, albumen

will be found by the usual tests, but in smaller quantity than in

Bright's disease. Albumen, with disintegrated epithelia, hyaline, and

large granular casts, as well as waxy casts, are peculiar to, and

characteristic of, this disease.

In the treatment of this malady, our specialist's experience has been

very great, and attended with marvelous success. Of course, after the

substance of the kidney has degenerated and broken down, and become

destroyed to any great extent, a cure is impossible. But that we now

possess remedies of great value, and specific power over this terrible

disease, we have the most positive evidence in the remarkable success

attended in its treatment. Most cases that are curable can be managed

successfully at a distance, the necessary medicines being sent either by

mail or express. Our specialists have cured many in this way who were so

bloated from dropsical effusion as to weigh twenty-five to forty pounds

more than usual. In our Sanitarium, where we have had the advantage of

our Turkish baths and other appliances, we have cured some cases in

which the removal of the dropsical effusion reduced the patient's weight

sixty pounds.

We cannot, In conclusion, too strongly condemn the general resort to

strong diuretics so often prescribed by physicians for all forms of

renal maladies, but which, by over-stimulating the already weak and

delicate kidneys, only aggravate and render incurable thousands of cases

annually. Not less harmful are the many advertised "kidney cures,"

"kidney remedies," "buchus," and kindred preparations. They all contain

powerful, stimulating diuretics, and, while they may appear for a short

time to do good, invariably render the case worse and far more difficult

to cure. The cases of Bright's disease reported cured by these

preparations are cases of far less dangerous maladies, made to appear,

by exaggerated accounts of them, as true Bright's disease. The use of

these general, ready-made or proprietary remedies in any case of true

Bright's disease is hazardous in the extreme. In no disease is there

greater necessity for treatment nicely adapted to the exact condition of

the patient (which should always be carefully ascertained by

microscopical and chemical examinations of the urine) than in this. As

it is a disease that runs a slow course, there is always time to send

samples of the urine for examination by expert specialists, and no other

physician than a specialist of large experience should be entrusted with

the treatment of a malady so dangerous in its character, and in the

diagnosis and treatment of which general practitioners commit such

frequent, and often fatal, errors. (SEE TESTIMONIALS.)

DIABETES. (POLYURIA AND GLYCOSURIA.)

There are two essentially different varieties of this disease, one of

which is called _Diabetes Insipidus_, or _Polyuria_, and the other

_Diabetes Mellitus_, or _Glycosuria_. The first is characterized by an

increase in the amount of urine excreted, and yields readily to proper

treatment. The second is characterized by the presence of sugar in the

urine, and under ordinary treatment often proves fatal.

The _causes_ are obscure, and are therefore not very well understood by

the profession.

SYMPTOMS. A notable increase of the quantity of urine excreted is the

first symptom which attracts the patient's attention. Frequently,

several quarts, or even gallons, of urine are daily excreted, and it is

paler than natural. The patient experiences extraordinary thirst, and

has an almost insatiable appetite, though at the same time he loses

flesh and strength. The tongue may be either clammy and furred or

unnaturally clean and red. The bowels become constipated, and a peculiar

odor is observed in the patient's breath and exhales from his body. The

skin becomes harsh, dry, and scurfy. There are dizziness, headache,

dejection, lassitude, and not unfrequently blindness, caused by

cataract, is developed in one or both eyes. The intellect is blunted,

and, as the disease progresses, the emaciation and debility increase,

and pulmonary diseases develop; or, perhaps, an uncontrollable diarrhea

sets in, and the patient dies from exhaustion.

In this disease, as in Bright's, we have many medicines that produce

specific curative effects, enabling our specialists to treat it with

greatly increased success. The disease is readily diagnosticated, or

determined, by chemical examination of the urine, so that we have been

enabled to treat this class of cases very successfully at a distance,

and without personal examinations. Great attention should be paid to the

diet in these cases. It should be highly nutritious, but anything of a

sweet or starchy nature must be avoided.

The following articles are wholesome and afford sufficient variety,

viz.: of animal food--beefsteak, game, poultry, fish, eggs, cheese,

cream, butter; of vegetables--spinach, dandelion greens, turnip tops,

watercresses, lettuce, celery, and radishes; of drinks--tea, coffee,

claret, water, brandy and water, beef-tea, mutton-broth, or water

acidulated with tartaric, nitric, citric, muriatic, or phosphoric acid.

The _forbidden_ articles are oysters, crabs, lobsters, sugar, wheat,

rye, corn or oatmeal cakes, rice, potatoes, carrots, bests, peas, beans,

pastry, puddings, sweetened custards, apples, pears, peaches,

strawberries, currants, etc., also beer, sweet wines, port, rum, gin,

and cider. (SEE TESTIMONIALS.)

CHRONIC INFLAMMATION OF THE BLADDER. (CHRONIC CYSTITIS.)

This affection, also called _catarrh of the bladder_, is an inflammation

of the mucous lining of this organ. It may occur at any period of life,

but it oftenest appears in the aged, and is usually associated with some

obstruction to the flow of urine.

CAUSES. It may be due to colds, injuries, irritating diuretics,

injections, extension of disease from the kidneys or adjacent organs,

intemperance, severe horseback riding, recession of cutaneous

affections, gout, rheumatism, etc.; but it more frequently results from

stricture of the urethra, enlarged prostate gland, gravel, and

gonorrhea. It is also caused by an habitual retention of the urine, and

sometimes results from masturbation or self-abuse.

SYMPTOMS. There is an uneasy sensation in the bladder, and heaviness and

sometimes pain and weakness in the back and loins. The urine is scanty,

and, although there is a desire to void it frequently, it is passed with

difficulty. If allowed to stand, it deposits more or less mucus, which

is sometimes mistaken for semen. As the disease progresses, the quantity

of the mucus increases. It is very viscid, and adheres to the sides of

the vessels, so that if an attempt be made to pour it out, it forms

long, tenacious, ropy threads. Sometimes the quantity of mucus is so

great that on exposure to cold the whole mass becomes semi-solid, and

resembles the white of an egg. The excreted urine is alkaline, acrid,

exhales a strong odor of ammonia, and soon becomes exceedingly fetid.

Sometimes the urine becomes so thick that great difficulty is

experienced in expelling it from the bladder. Nocturnal emissions,

impotency, and loss of sexual desire are apt to ensue. Occasionally

there will be a spasmodic contraction of the bladder, with straining and

a sensation of scalding in the urethra, and sometimes the patient is

unable to urinate.

When ulceration occurs in the progress of the disease, as it is apt to

in its advanced stages, blood will occasionally be seen in the urine. In

the advanced stages of the disease the system becomes greatly

debilitated, emaciation supervenes, with hectic fever, nervous

irritability and, finally, death.

TREATMENT. A strict observance of the rules of hygiene is essential to a

cure. We must ascertain the cause if possible, remove it, and thus

prevent it from perpetuating the disease. The various causes and

conditions involved in different cases demand corresponding

modifications of treatment; hence, it is useless for us to attempt to

teach the non-professional how to treat this complex disease. We have

succeeded in curing many severe cases without seeing the patient, being

guided in prescribing by indications furnished by microscopical and

chemical examinations of the urine. (See Urinary Signs in Appendix.) In

fact, nearly all cases can be cured at their homes, and without a

personal examination being made. In the worst cases, we have found it

best to have our patients at our institution, where we can wash out the

bladder with soothing, healing lotions, and thus make direct

applications to the diseased parts. (SEE TESTIMONIALS.)

GRAVEL.

When the solid constituents of the urine are increased to such an extent

that they cannot be held in solution, or when abnormal substances are

secreted, they are precipitated in small crystals, which, if minute, are

called _gravel_. Another cause of the precipitation of these salts is a

stricture of the urinary canal which, by interfering with the free

expulsion of all the fluid from the bladder, results in the retention of

a portion, which gradually undergoes decomposition. Salts from the urine

are thus precipitated in the same way that they are thrown down in urine

which is allowed to stand in a vessel. Any one can illustrate this, by

allowing a small quantity of the urinary secretion to stand for a few

days either in an open or a closed bottle. Soon a white, flaky deposit

will be observed, which will become more and more dense, and finally

fine grains will be seen precipitated at the bottom of the bottle.

Similar grains, lodging in the folds of the bladder, gradually increase

in size, by the precipitation of more salts around them, and ultimately

become a source of much irritation. When of large size, they are termed

_calculi_ or stones. When these formations occur in the kidneys they are

termed _renal calculi_; when in the bladder, _vesical calculi_. There

are several varieties of gravel, each depending upon different

conditions of the system for its formation. The two prominent varieties

are the red, containing uric acid, and the white, or phosphatic, gravel.

SYMPTOMS. When the deposits are in the kidneys, there is pain in the

back and loins, occasionally cutting and severe; sometimes it darts down

the course of the ureter to the bladder, and extends even to the thighs.

When the deposits are in the bladder, there is a frequent desire to

urinate, with a bearing-down, straining pain; also a cutting or

scratching sensation in the urethra during micturition. In the male,

intense pain is often experienced at the end of the penis. When the

urine is voided in a vessel and allowed to settle, a gravelly deposit is

seen, generally of a red or a white color, and the particles varying in

size.

TREATMENT. These urinary deposits indicate a general derangement of the

system, as well as a local disease. Nutrition is imperfect and some of

the excretory organs are not properly performing their functions, or,

perhaps, some portion of the body is being too rapidly wasted. Very

frequently we find these gravelly formations as the result of a

rheumatic or a gouty diathesis. It is also a well-known fact that

torpidity of the liver throws an excessive amount of work on the

kidneys. These organs then, in part, perform the function of the liver,

and hence unnatural activity is required of them, and the secreting of

such substances as uric acid, which precipitates readily and gives rise

to severe irritation of the urinary canal.

In order to treat these cases rationally and successfully, it is first

necessary to ascertain by microscopical and perhaps chemical

examinations, the character of the deposit. By such an examination, the

exact condition of the system which gives rise to these abnormal

products may be definitely determined, and the remedies to be employed

indicated. As the non-professional are not qualified to make such

examinations, it would be useless for us to suggest specific treatment

for the various forms of this affection.

Samples of the urine may be sent to us with a brief description of the

symptoms experienced, and the proper medicines to cure can be returned

by mail or express. Our specialists are treating, with uniform success,

large numbers of cases in this way. (SEE TESTIMONIALS.)

STONE IN THE BLADDER.

Few affections to which the human flesh is heir are more painful than

this terrible affliction. The cutting operation heretofore required to

remove it, is considered one of the most dangerous operations that the

surgeon is ever called upon to perform.

The death of the Emperor Louis Napoleon, of France, from an operation

for the removal of a stone, at the hands of surgeons renowned for their

skill, gave new impetus to the efforts of surgeons to invent some method

that would be less dangerous than that which has been heretofore

commonly employed. The cutting operations have been the rule. Of these

the operation by median-section is the safest, and is most commonly

employed for the removal of stones that are not too large, while the

lateral operation is used where the stone is more than about one inch in

its smallest diameter.

As will be seen by the consultation of any hospital record, the deaths

in these various operations have been, in adults, from one in three to

one in every four cases--a very large percentage, and sufficient to

deter any sufferer from undergoing an operation except for the relief of

a condition which is in itself worse than death. Even when this alarming

death-rate is explained to sufferers, they willingly undergo the

operation, feeling that they would rather die than longer continue in

their pain and anguish.

Our specialists, not satisfied with the results of these operative

measures, in their studies of the disease endeavored to perfect some

other means by which these foreign bodies could be removed from the

bladder without such great danger and pain. The operation by crushing,

and removal without cutting, appeared to them to present the most

practicable advantages, and they therefore devote their entire time to

the improvement of this method for the removal of stone.

The method of crushing was first invented by a French surgeon many years

ago; but, owing to his crude instruments, and the difficulty that was

experienced in expelling the pieces of stone, the operation was seldom

employed by surgeons. The improvements in these methods at the hands of

Bigelow and Sir Henry Thompson, with those that have been made by our

specialists, have resulted in our being able to present to sufferers

with this disease, a means of cure which is, we are assured, the most

successful known to modern medical science.

There have been so far in the history of the treatment of this malady by

the new method of cure, one hundred and twenty-odd cases operated upon

at the hands of prominent surgeons, all of which were with less perfect

methods than that of our specialists, and there were but four deaths in

this large number. By the advantages which are the result of further

improvements by our specialists, we can assure you that this mortality

is even less in our hands; in fact, approaches, as near as possible, to

a perfect method of cure.

We think that in a moderately healthy subject, one in which the kidneys

are not badly diseased as the result of irritation from the calculus,

the operation is almost absolutely safe. The method consists in the

crushing of the stone, and its removal from the bladder by means of

small silver catheters attached to an apparatus which gently and

perfectly removes, by suction, all the pieces which are thrown to the

bottom of the bladder. This operation has now been performed in our

institution in a very large number of cases with uniform success, and

the cures have been effected in from six to eight weeks without a single

unpleasant symptom arising during their progress. By this method it is

not necessary to remove the entire calculus at one operation, if it is a

large one. By the old cutting operation this was required, as the

bleeding was great, and what was to be done had to be done immediately,

or the patient would die from the _hemorrhage_. With the new method a

part of the large calculus, or when several exist, one or two of them,

may be removed at a time, after which the patient can rest and gain

strength for the second; or, if necessary, for the third operation.

The largest stone removed by us in this way was one weighing between

seven and eight hundred grains, for which three operations were

required. It is necessarily performed under a mild anæsthetic, which

prevents suffering and secures the perfect relaxation of the patient. In

the case in which this large amount of stone was removed we feel certain

that a cure could not possibly have resulted from a cutting operation,

as the heart was seriously affected, and the physical condition of the

patient so low, as the result of years of suffering, that death would

have occurred while undergoing the operation. By carefully pursuing the

new method, and not prolonging the sittings more than a few minutes each

time, the entire stone was evacuated. The health of the patient

constantly improved during the interval of three operations, which

covered a space of seven weeks. This stone was as large as a hen's egg.

Small calculi or gravel are readily removed in a few moments' time by

the new method. In no case is there any bleeding. Instead of a large,

gaping wound being left after the operation, from which secondary

hemorrhage may take place, or poisoning result from the irritation of

decomposing urine, the parts are left in a healthy state with the

surface unbroken. The stone, a constant source of irritation, is

removed, and the health is speedily restored.

When it is impossible for the patient to visit us, a careful examination

of the urine is made, and if gravel have been passed, these are

carefully examined also. An idea of the composition of the stone is

arrived at by this means, and treatment is directed to dissolve it.

Success has commonly followed this method of treatment, when the stone

has not been very large. With the gradual reduction of the size of the

stone the irritation subsides, and the general health of the patient

improves. (SEE TESTIMONIALS.)

CHRONIC ENLARGEMENT OF THE PROSTATE GLAND. (HYPERTROPHY.)

The prostate gland lies just in front of the base of the bladder, and

surrounding the urethra, or urinary canal. Enlargement, therefore, of

this body, if it be of considerable extent, causes it to encroach and

press upon the base of the bladder, and to more or less constrict the

urinary canal near the base or outlet of the bladder. The enlargement

may be only slight, or the dimensions of the gland may be increased from

the size of a large chestnut, its normal dimension, to the volume of a

pullet's egg, or even to the size of an orange.

Hypertrophy of the prostate generally arises from causes which operate

in a slow and permanent manner. Whatever has a tendency to produce a

determination of blood to, and an engorgement of, this organ, is capable

of producing the affection, an augmented flow of blood to the the part

having the effect to increase the nutrition. Among the most frequent

causes of this affection, are excessive venery, masturbation, disease of

the bladder, stricture of the urethra, horseback exercise, gonorrhea,

and the employment of strong, stimulating diuretics. Some of the worst

cases that we have had to deal with have occurred in old men, and, in

fact, the malady is more common to those advanced in life; but it is

frequently produced in those of middle age by the causes enumerated.

Among the earliest symptoms of the disease is an uneasy feeling in the

region of the base of the bladder. There is a more frequent desire to

urinate than usual, and, in the course of time, this frequency becomes

more urgent; still no particular notice may be taken of it, it being

considered as "only a slight inconvenience." After several months, or it

may be years, the discomfort increases, and nightly calls to empty the

bladder become habitual. By and by the patient begins to find the

discomfort of getting out of his warm bed very troublesome; still no

notice to taken of it. He does not consider it worth his while to

consult a doctor for "such a trifle." In the course of time the patient

is obliged to get out of bed twice during the night instead of once.

Afterwards, the calls become still more frequent and urgent; the

inconvenience more evident; finally, pain is substituted for

inconvenience, and then the doctor is consulted. Unless a specialist of

experience be consulted, the bladder will most probably be examined, and

medicine will be prescribed only to excite the kidneys to secrete more

urine, which does harm instead of good; the disease slowly, but surely

progressing. Patients often write us that they have had something wrong

with the bladder for a number of years, having to urinate more

frequently than they ought; sometimes having to do so three and four

times during the night; in extreme cases even every half hour or so, and

that they are not able to pass it freely, but only in small quantities,

and attended with much pain. These symptoms are not always constant, but

let up for a few weeks and then appear again. Things go on in this way

for a year or two, perhaps, when the passage of the urine is completely

shut off for several hours, and the patient is in great agony until the

bladder is relieved by the use of the catheter. After such instrumental

relief, for a day or two the urine may be natural again, coming at

first, perhaps, in very small quantities, but by and by more freely.

Then, after a week or two intervening, there may be another complete

stoppage, attended, as before, with intense suffering, which will have

to be again relieved by the use of an instrument.

The foregoing is a fair account of the usual progress of the disease and

its symptoms. As the prostate gland becomes more irritated and inflamed

from the natural progress of the disease, or from the irritation caused

by the passage of instruments, or the employment of strong, harsh,

stimulating diuretics, the urine becomes cloudy, and still later is

found to have deposited during the night in the chamber utensil a

quantity of thick, tenacious, and usually offensive mucus. There is apt

to be more or less discomfort in the rectum, or lower bowel, produced by

the pressure of the enlarged prostate upon it. Rarely, the first

intimation of a large prostate occurs through a sudden retention of the

urine, and the patient being under the impression that there was nothing

wrong with the organ previously. Closely questioned, however, the

information is elicited that there has been a long train of mild

symptoms, similar to those that we have described, preceding the attack

of retention of the urine. This shows the importance of early attention

and proper treatment when such symptoms are manifested. However slight

the inconvenience experienced, it should not be neglected. The disease

should be brought under control at the outset by skillful and

nicely-adapted treatment. Usually before a person suffers from

toothache, the decay occasioning it has been gradually progressing

without pain for from five to eight years. Just as the decay of the

tooth may be arrested by the early attention of the dentist, so may

prostatic disease by early attention be not only promptly relieved, but

permanently cured.

Disease of the prostate being slow in its inception and progress, is

also slow to yield even to the most skillful treatment. Being slow to

develop, patients rarely seek assistance until the organ has become so

large as to be seldom restorable to a size where mechanical means can be

wholly dispensed with for relieving the bladder. Most surgeons are too

much in the habit of depending on the catheter for the relief of the

patient, and usually instruct the sufferer how to use it, telling them

that this, the catheter, is to be their only doctor for life. Great as

is the relief afforded by the catheter, which has often saved life, yet

it is a fact that its frequent and prolonged use often renders disease

of the prostate very intractable and often wholly incurable. Frequent

use of the catheter, without any treatment to prevent the further

enlargement of the diseased gland, or to reduce its size, permits the

part to go on enlarging, and, besides, the constant use of the catheter

irritates the prostatic portion of the urethra, causing thickening of

the lining membrane, and sooner or later a more or less complete organic

stricture of this canal, depending upon thickening of the lining mucous

membrane, as well as upon the encroachment of the gland itself upon this

canal. Besides, when the use of the catheter is once commenced, even

when the enlargement is not very great, it is with the utmost difficulty

that we have been able to induce patients to leave off its use. The

bladder, becoming accustomed to its use, refuses to obey the will

without this help. The irritation set up in the parts by the friction of

the catheter causes inflammation and exudation in the lining membrane.

This extends to the structure of the prostate itself and increases the

hypertrophy or enlargement. It will, therefore, be seen how important it

is to early resort to treatment to relieve the first manifestations of

this affection. A disease of so delicate a nature, and one so often

confounded with other maladies by inexperienced physicians, should only

be intrusted for treatment to expert specialists of large experience in

the management of this and kindred maladies.

* * * * *

STRICTURE OF THE URETHRA.

Stricture of the urethra generally results from some specific disease of

the urethra, but may be caused by sexual excesses, exposure, or strain,

or by the practice of masturbation or self-abuse. It runs a course

varying in time from a few days to many weeks or months, during which

time the patient is often unaware of the real cause of his sufferings.

Commonly, the attention is first called to a stricture by a slight

discharge, or smarting sensation, or the appearance of an undue amount

of mucous deposit in the urine. Occasionally, some difficulty in

starting the water, or a diminution in the size and force, or a twisting

of the stream as it flows, is the first symptom. This passive stage is

of variable duration. When skillful treatment is instituted at this

stage of the disease, a speedy cure is easily effected without pain or

danger. Any exposure, improper use of instruments, or irritating cause,

may speedily give rise to the alarming symptoms due to closure of the

urethra, from which fatal consequences may suddenly ensue.

[Illustration: Fig. 2.

A Single Stricture of the Urethra.]

This condition is illustrated in Fig. 2, which shows the hard and tough

stricture which surrounds the soft mucous membrane that lines the

urinary canal. When irritated or inflamed, as the result of a cold or

other cause, the mucous membrane becomes swollen and thickened, and, as

the stricture will not yield and enlarge, the result is that the urethra

is almost completely closed, and it becomes impossible to pass the

urine. Great pain is experienced, and the surgeon has to be called to

draw off the urine with a catheter, which, at best, is a very difficult

and painful operation, when the urethra is so irritable and constricted.

TREATMENT. In the earlier stages of the malady, relief is given by the

skillful use of instruments for dilating the canal, or, where this fails

by the operation of urethrotomy, for which we employ an improved and

ingenious instrument, by which the stricture is readily and almost

painlessly divided.

IMPROVED METHODS. Our surgeons have operated upon many hundreds of bad

cases by a very ingenious and almost painless method, that requires no

use of bougies in the after-treatment. This saves the patient an immense

amount of pain and annoyance, and enables him to go home almost

immediately after the operation.

The ordinary after-treatment, by dilatation with bougies, is very

tedious, and often more painful than the operation itself, so that our

peculiar method of treatment has been hailed with joy by those familiar

with the old and unnecessarily-painful systems of treatment. Besides,

our more improved method has been followed by far more perfect cures in

every case operated upon.

In many of the cases coming under our observation and treatment, there

have been several strictures, as illustrated in Fig. 3, which shows the

urethra constricted at three different points, besides a congenital

contraction at its mouth or meatus.

[Illustration: Fig. 3.

Condition of the Urethra with three Strictures and a congenital

contraction

at the meatus or outlet.]

SPERMATORRHEA not infrequently results from stricture of the urethra,

even when the affection is quite slight. Our attention was first called

to this subject by the consideration of the numerous cases in which

epileptic convulsions or "fits," and other serious diseases of the

nervous system in children, have resulted from an unnatural contraction

of the prepuce or foreskin, constituting what is termed _phimosis_.

Every surgeon of experience has met with many of these cases of reflex

irritation. It occurred to us, that, inasmuch as these contractions of

the foreskin give rise to nervous diseases of an alarming nature, may

not an unnatural narrowing of the urethral canal, which must have

exactly the same effect in retarding the flow of the urine, give rise to

irritable nervous affections in adults. May not unnatural irritation and

excitement of the sexual organs, so set up, cause loss of semen to occur

during sleep, and consequent nervous and general debility?

It is a well recognized fact that the urethral canal should bear a

certain definite and proportionate size to that of the penis, just as

the length of the arm should naturally bear a certain proportion to the

length of the body. In the case of some parts of the body,

disproportionate development of the part may not give rise to anything

further than unsightliness; but when we find the small size of the

urethra retarding the free passage of the urine, then we may expect, if

this condition is long continued, to find more or less irritation of the

urethra and, perhaps, of the bladder, also. When there is a contraction

of the urethra at its external orifice, or at any point along its

course, unnatural pressure is put upon the urinary canal behind the

constricted portion, and these parts must bear an undue strain during

the passage of the urine.

It is a well established fact that improper diet, cold, exposure, and

over-work exert a very powerful modifying influence upon the urinary

secretion, frequently causing an acrid and irritating condition of this

fluid. This condition, when associated with a contracted urethra, must

result in irritation of the mucous membrane lining this canal back of

the stricture, if long continued or frequently repeated. As an

illustration, we have a hose pipe from which, by means of a small

nozzle, water is expelled a considerable distance, but a great tension

is put upon the hose behind the nozzle. If the pressure is increased

greatly the hose will burst; but, if the small nozzle be replaced with a

larger one, the projection of the stream will be quite as great, but all

undue tension of the pipe is overcome and the danger of bursting is done

away with. We have, in an unnaturally contracted urethra, a favorable

condition for the development of disease in the urinary canal and

adjacent parts of the generative organs. Irritation is set up in the

urethra behind the stricture by undue strain in passing water, and the

frequent reoccurrence of acrid urine, as the result of any of the causes

we have already mentioned, this irritation keeps gradually increasing.

It will be felt more during the periods when the urine is acrid, but may

pass unnoticed even at such times. The seminal sacs and the prostate and

Cowper's glands communicate with the deeper portions of the urethra by

means of canals or ducts, lined with mucous membrane which is continuous

with the urethral mucous membrane. Hence we can readily see that not

only by reflex nervous irritation are those parts debilitated, through

the contraction of the urethra, but the affection is apt to extend by

continuity of the mucous membrane, and thus become more and more

manifest, through symptoms of disease of the testicles, prostate gland

and seminal vesicles, and these disorders become more and more seated

the longer the morbid condition of the urethra is allowed to run on,

until there may be an entire loss of the sexual functions, occurring at

an age when there should be present the most vigorous manhood. From no

other cause can we explain the common prevalence of disease of the

deeper portions of the urethral canal and bladder, many times confounded

with other diseases of the urinary and generative organs.

The following is the history of a case that fully illustrates the

foregoing statements:

CASE 112,289. MR. O.C.E., SINGLE, 32 YEARS OF AGE.

[Illustration: Fig. 4.

Condition of the urethra in Case 112,289; permanently cured at the

Invalids' Hotel and Surgical Institute.]

He applied to us suffering from entire loss of the sexual

function, with great nervous debility, and there was a thin

slimy discharge from the urethra, and the usual symptoms of

melancholia and weakness. He had lost all taste for business,

and was extremely nervous, from the fact that he was engaged

to be married, and felt that his condition would not permit

it. On examination a contraction of the urethra was found at

the point shown in Fig. 4, which had probably been present

for years. He stated that he never had been just right in

those parts, but had lived a virtuous life, had never had any

venereal disease, and, hence, the true nature of his trouble

had not been suspected. With the removal of the stricture

there was an immediate improvement in his condition, which

became more and more rapid, as his system gained strength and

reaction became manifest. At the end of two months he wrote

that he felt sound and well, and that he had experienced the

most wonderful improvement in every way. His vital strength

was fully restored, and he was most profoundly grateful.

Chronic inflammation of the bladder, sometimes called catarrh of the

bladder, an affection that is elsewhere herein fully treated of, and

chronic inflammation of the kidneys, and true Bright's disease, as well

as prostatic disease, are all liable to result from strictures of the

urethra. Hence, it behooves one suffering from this malady to have it

promptly and skillfully treated.

FALSE PASSAGES. In very rare cases of impassable stricture, or in which

fistulous openings, or false passages, have formed, through which the

urine flows or dribbles away, we have resorted to the operation of

perineal section with the most gratifying results. The cases requiring

this operation are rare ones, in which death must generally result but

for the relief afforded by the operation.

DANGEROUS USE OF INSTRUMENTS. The worst and most dangerous cases of

stricture with which we have met, in a long and extensive experience,

were rendered thus by the careless or unskillful use of bougies,

catheters, or sounds. Many surgeons and physicians are most recklessly

careless or unskilled in the use of these most dangerous instruments, as

the many cases of false passage or stricture of the most painful and

dangerous kind, caused or aggravated by their ignorant or improper use,

sorrowfully testify.

DELAY DANGEROUS. By proper treatment of stricture in its early stages,

all danger and pain are avoided, and a cure is effected in a very short

time. In an extensive practice, in which we yearly treat hundreds of

cases, we have never yet failed to give perfect and permanent relief

from stricture, or diseased prostate or urethra, without the necessity

of cutting instruments of any kind, when we have been consulted before

injury of the urethra has been produced by improper use of instruments.

Having specialists who devote their entire time to the study and cure of

these diseases, we are thereby enabled to attain the highest degree of

skill in the management of these cases.

GREAT SKILL REQUIRED. The urethra is a sensitive and delicate canal, and

is surrounded by tissues the most delicate, and lined with mucous

membrane which is highly vascular and filled with sensitive nerves. The

introduction of any instrument is to be undertaken only when absolutely

required, and, when necessary, it should be so skillfully and carefully

effected that no pain or irritation can result. The slightest

awkwardness is liable to cause an unnoticeable injury, which results in

false passage or an effusion of plastic lymph around the canal, and as

it organizes, the formation of the most troublesome organic stricture.

The attention not only of sufferers, but also of the profession, is

called to the remarkable success of our operation, perineal section, by

which a cure of extremely bad cases of impassable stricture and false

passages, or urinary fistulas, is effected in from thirty to forty days,

and with very little suffering. That we have been successful in such

cases must be considered as conclusive evidence that no case of

stricture, false passage, or urinary fistula, is beyond the reach of our

skill.

* * * * *

TESTIMONIALS.

In a practice embracing the treatment of a vast number of cases of

diseases of the Urinary Organs, it has been our good fortune to effect

many remarkable cures. The experience gained in this field of practice

has made our specialists skilled experts, and hence hundreds consult

them as a last resort. In fact we seldom get a case, in this line, that

has not been the rounds of the home physicians before applying to us for

relief and cure. The cures, therefore, which we shall introduce here are

the more remarkable because of the failure, in nearly every case, of

other medical men to benefit or cure. They are not the every-day,

ordinary cases met with in the general practitioner's rounds, but

complicated, obstinate ones, which had generally been given up as

hopeless before coming to us.

CASE 4A-3431. "WASTED TO A SHADOW." BLEEDING FROM KIDNEYS. A SEVERE

CASE.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

[Illustration: T.S. Bailey, Esq.]

_Gentlemen_--I think it my duty to write to you concerning my case. In

the year 1886 I was seized with inflammation of the bladder and passed

nothing but thick blood, owing to heavy work, and I consulted a doctor

and he said there was no cure for such a bad case; but he gave me

medicine and it relieved me at the time I used it; and I took 16 bottles

and I got worse and wasted to a shadow. I quit taking the medicine, and

other complaints came, as rupture in the spermatic cord, for which I

applied to you and soon got relief. And in 1891 the bladder disease made

its appearance, and I wrote to the Invalids' Hotel and Surgical

Institute and got no reply as our mails were stopped on account of snow

drifts. I sent for the best doctor in Listowell and I still got worse,

and he said I might live three or four weeks, but there was no stoppage

of the disease. And I got so weak that I had to support myself by the

furniture in my room; and I wasted down to 100 lbs. in two weeks; and I

applied to your Institute and I received my medicine in a few days, and

in two weeks I began to gather strength and now I am hearty and well and

my weight is 145 lbs. I feel so thankful to the Medical Association and

its Staff of skilled men. It is 15 months since I quit taking your

medicines and no signs of the disease returning.

Yours gratefully,

THOMAS S. BAILEY,

Dorking, Wellington Co., Ont.

CASE 23A-877. INFLAMMATION OF THE BLADDER, WITH OTHER COMPLICATIONS.

SUFFERED EXCRUCIATING PAIN IN URINATING.

[Illustration: G.W. Heffner, Esq.]

For many years I suffered with inflammation of the Prostrate Gland and

Bladder. It became gradually worse and I endured extreme pain, so much

so that I was laid up for weeks at a time, and almost gave up in

despair. I was persuaded to go to the Invalids' Hotel and Surgical

Institute. I have never regretted following this advice. While there I

submitted to an operation by their specialist. This was entirely

painless and the result perfectly satisfactory. I left in a short time

delighted, and have since been strong and well. I cannot speak in too

high praise of this famous Institution; the rooms are large and

pleasant, the food the very best, the attendants kind and attentive and

the staff of physicians skillful and of large experience. I highly

recommend all invalids to the World's Dispensary Medical Association. I

feel confident that all the benefit to be derived from medical treatment

is to be received at this Institution.

Yours truly,

GEO. W. HEFFNER,

Chicago, Ills.

CASE 2A-103. INFLAMMATION OF BLADDER, COMPLICATED WITH KIDNEY DISEASE.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

[Illustration: M. Manheim, Esq.]

_Gentlemen_--Having been a patient in your Invalids' Hotel for several

weeks, I take great pleasure in telling other sufferers of my treatment

which I received under your efficient staff of physicians, surgeons and

nurses, and I will say with clear conscience that every care and comfort

was given me that could be wished for. I am sure that your Institution

is far in advance of the age, and would wish that every invalid could

avail himself of the treatment that I received in your most excellently

kept Invalids' Hotel. I cheerfully give this as my testimonial to

individuals, friends and sufferers. My health is so fully restored that

I look upon life with pleasure and comfort, whereas before I was a

suffering, nervous invalid, unable to sleep and much of the time in

torment. Wishing you success,

I am your friend and well wisher,

M. MANHEIM,

Georgetown, S.C.

CASE 859,143. BLADDER, RECTAL, KIDNEY AND LIVER DISEASE. "ENTIRE URINARY

ORGANS ONE MASS OF SORES." "DESPAIRED OF CURE."

[Illustration: S.C. Tracy, Esq.]

My disease was caused by the roughness and exposure incidental to the

life of a miner, working in the gold mines of California and Montana. I

had much of the time to work in water, with my clothes wet, which

finally brought on a severe pain In my kidney, which ere long completely

prostrated me. I employed and was treated by six different physicians,

the best I could obtain in my section of country, and who while seeming

to understand the nature of my disease, yet gave me no remedy that

afforded me any real relief. I grew worse under the treatment of them

all. The pain in the kidney left me, but immediately located in the

bladder. My bladder became very painful and commenced to ulcerate and

fill up. It seemed from the excruciating agony I suffered, that there

must have been an abscess in either the kidney or bladder, and from the

large amount of pus discharged at one time, it appeared to me that my

kidneys, bladder and the entire urinary organs were one mass of sores

and pus mixed with blood. I had to use injections of laudanum daily in

the lower bowels to ease the pain and live. Was reduced by long

suffering, looking for each day to be my last. I felt that no human

power on earth could help me. No language can describe, and God only

knows, the agony I suffered. From what I have already written, you may

form some faint conception of my physical condition at the end of six

years' treatment by the best medical aid I could get in the section

where I was living. I also used for some time (with no benefit),

"Warner's Safe Cure," and in fact, tried every means that I could hear

of, but to no permanent relief. Such was my condition when I was led

finally to consult and be treated by your Association, though I had but

faint hope of obtaining any relief from any one. With the very best

description I could give in writing of my case, and all the information

you got from me, you would not undertake the case until you were further

informed, and for which caution I sincerely thank you. You wrote me--"we

are at a loss to definitely determine your condition. We have an opinion

based upon the facts before us, but we feel that we must have a personal

examination." In the condition I was then in, I could not have been kept

alive to reach the first railroad station, which was only six miles from

my house, and much less to travel to Buffalo. Indeed I wrote you, that

if you would cure me for nothing, I was unable to go to you. In reply,

you then advised me to take your "Special Remedies" until I could

improve sufficiently to go to Buffalo for examination. Now this frank

answer of yours, removed every doubt from my mind, and convinced me that

you were _honorable physicians_. On March 10th, 1883, I began taking

your "Special Remedies," as you prescribed them, and at the end of three

years' constant treatment, I was improved sufficiently to go to Buffalo

to your Institute, where I was examined as you required of me. When I

reached your Institute, I was there carefully examined and received a

month's treatment. When I reflect on my condition and my suffering when

I first began to use your specifics, and see what I am now, I feel that

no words can too glowingly express my gratitude to your Association for

the physical benefits you have conferred upon me by your treatment of my

despaired-of case.

SAMUEL C. TRACY

Platteville, Wis.

DOUBLE VARICOCELE AND STRICTURE OF THE URETHRA.

[Illustration: C. Hanson, Esq.]

WORLD'S DISPENSARY MEDICAL ASSOCIATION, 663 Main St., Buffalo, N.Y.:

_Gentlemen_--I have taken treatment from you for several months for

nervous debility, and although I am not quite fully cured as yet, I have

been greatly benefited, and believe, if I had come to you before I was

duped and swindled by different quacks and was more dead than alive, I

would to-day be a thoroughly well man.

I have also been to your Institute twice for surgical operations, and

cannot too highly praise the Hotel, or the skill and care of the

attending surgeons and nurses. They are gentlemen in every way and the

Invalids' Hotel is just as represented.

I shall advise all suffering from chronic diseases to go to you for

relief, as I have never seen any one there who was not cured or greatly

benefited.

Very truly yours,

CHRISTIAN HANSON, Esq.

Austin, Mower Co., Minn.

CASE 23A-890. DISEASE OF THE URINARY ORGANS.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

[Illustration: F.A. Empsall, Esq.]

_Gentlemen_--I feel it my duty to give my testimonial in behalf of your

grand Institution. I had an operation performed at your place two years

ago for the relief of a very painful disease of urinary passage, and,

thanks to your skill, I was cured, and have enjoyed the best of health

since. I earnestly recommend your Institution to all who are suffering,

and still further let me thank you for the kindness I received at the

hands of everybody connected with the Institution. I am,

Respectfully yours,

FRANK A. EMPSALL,

P.O. Box 980, Pittsfield, Berkshire Co., Mass.

CASE 2A-208. RETENTION OF URINE. SUFFERED INTENSE PAIN.

[Illustration: P.J. Hamill, Esq.]

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

_Dear Sirs_--To your favor of the 20th ult., would say that I can only

speak in the highest terms of your Institution. After suffering for ten

or twelve years with retention of the urine, and bladder difficulties, I

can say that I found immediate relief at your hands. When going to your

place, about six years ago, I was suffering with intense pain, loss of

appetite, and unable to eat a good meal. I now weigh 170 lbs., do a good

day's work and feel well in every respect. I am only too glad that I am

able to praise your Institution, and can highly recommend it to any one

who is suffering as I was. With great respect, I remain.

Yours very truly,

P.J. HAMILL,

Utica, N.Y.

CASE 80,115. ENLARGED PROSTATE AND CHRONIC CATARRHAL INFLAMMATION OF

BLADDER.

[Illustration: Abraham Schell, Esq.]

Several years ago I had occasion to become an inmate of the Invalids'

Hotel and Surgical Institute, No. 683 Main Street, Buffalo, N.Y. I was

afflicted with an enlarged prostate and chronic Inflammation, or

catarrhal condition of the bladder. I was largely benefited by the

treatment I received there, and had I remained a little longer, as I was

advised to do by the doctor who attended me, I should have fully

recovered. I was so nearly cured that I did not think it necessary to

remain longer, as I supposed nature would do for me what remained to be

done, to effect a perfect cure. My business was urgent. I could not well

remain longer. In this I made a mistake, I should have remained longer.

I was seventy-two years old at the time. I bear willing testimony to the

ability of the medical staff and the interest the doctors take in the

welfare of their patients. The nurses and all the subordinates were very

kind and seemed to vie with each other to contribute to the pleasure and

happiness of the inmates of the Institute. One will find the Institute

equipped with all the improvements known to modern science, for the

promotion and restoration of health. It is impossible to do justice to

its merits in a short article of this kind. Persons must go there and

see and judge for themselves, of the wonders of this extraordinary

medical establishment. If they cannot recover their health there, in my

Judgment, it is of no use to go elsewhere.

ABRAHAM SCHELL,

Knight's Ferry, Cal.

CASE 820,804. OBSTINATE AND COMPLICATED DISEASE.

[Illustration: John H. Smith, Esq.]

WORLD'S DISPENSARY MEDICAL ASSOCIATION:

_Gentlemen_--Yours of July 12th to hand. I am only too glad to comply

with your request. Having suffered for many years with a complication of

diseases and feeling conscious that they were rapidly making serious

inroads upon my constitution, and that I was speedily becoming unable

and incapacitated to attend to my ordinary business. I resolved, after

reading a number of testimonials from your patients, to place myself

under your treatment at the Invalids' Hotel and Surgical Institute. With

heart-felt gratitude I can truthfully say I am relieved of my trouble. I

most cheerfully and earnestly recommend this Institution to all who are

afflicted with chronic and painful diseases, no matter of what nature.

During my stay there I saw some wonderful cures and surgical operations.

Yours truly,

JOHN H. SMITH,

Deckertown, Sussex Co., N.J.

CASE 520,425. COMPLICATION OF DISEASES.

[Illustration: Andrew Holes, Esq.]

Without solicitude or hope of pecuniary reward, with heart-felt

gratitude and a desire to aid my fellow-man to health and happiness,

allow me to state, that as an inmate for more than a month of the

Invalids' Hotel and Surgical Institute at No. 663 Main Street, Buffalo,

N.Y., I feel warranted in its highest recommendation. While there I saw

and talked with a great number of people who came there as a last

resort, to be cured of almost every chronic disease to which flesh is

heir, and they were unanimous in their praise of the Institution and the

skilled specialists who constitute its professional staff.

ANDREW HOLES,

Moorhead, Minn.

CASE 654,500. DISEASE OF KIDNEYS AND OTHER COMPLICATIONS CAUSED BY

EXPOSURE AND MALARIA.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

[Illustration: J.W. Dean, Esq.]

_Gentlemen_--Having spent a short period of time at the Invalids' Hotel

and Surgical Institute, No. 663 Main Street, Buffalo, N.Y., I must say I

found it fully equal in every respect to the claims made for it by the

proprietors. It was filled with invalids who were under the care of a

corps of physicians and surgeons and the fact that all the sick people

appeared to be improving, and that they were both cheerful and hopeful,

and that they all spoke well of the Institution and of its doctors, was

calculated to inspire confidence in one who went there himself to be

treated. The greater number of these cases, as far as I was able to

learn, were chronic and of a complicated character. They represented a

wide range of the States and Territories of the Union, and had in each

exhausted the resources of the home physicians. Having myself been

treated by your Faculty for a complication of troubles induced by

exposure and malaria, I feel that I owe my restoration to health to your

skill and devotion, at a time when I was unable to perform labor and was

much discouraged, and had failed to obtain relief elsewhere. You are at

liberty to make any use you may desire of this communication.

Very respectfully yours, J.W. DEAN,

Chariton, Putnam Co., Mo.

CASE 620,230. DIABETES AND INFLAMMATION OF BLADDER, GIVEN UP BY HIS HOME

DOCTORS AS SURE TO DIE IN A FEW WEEKS. RESTORED TO ACTIVE WORK ON HIS

FARM.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

[Illustration: J.D. Parks, Esq.]

_Gentlemen_--I received your kind letter the 12th, and was glad to hear

from you and have no objection to your making use of my name in any way

to help the sick and suffering, for I know what it is to be sick. I was

sick for seven years; could not do anything; was visited by seven

doctors and was treated by four, and was given up to die by one of the

best doctors of Russellville. He said I could not live longer than fall.

He treated me for Sugar Diabetes, while the rest said I had inflammation

of the bladder. After giving up all hopes of being cured at home, a

friend got me to write to Dr. Pierce's Institution and after

corresponding: awhile I decided to go and be treated. I was there one

month and I never was cared for or treated more kindly by any one. No

parents could have been better to their sick children. I cannot speak

too highly of the Institution, and I believe I would have been in my

grave to-day if I had not gone and been treated.

I feel great pleasure in expressing to you my sincere thanks for the

cure that has been effected in my case, by your very skillful treatment,

whereby I am now entirely and I trust permanently cured from a dangerous

disease, which had defied the utmost skill of all former medical

attendants for the past five years, and from which I had despaired of

being: relieved. I am happy to state that my health is so good since

taking the month's course of treatment at your Institute, and, the home

treatment since my return, that I am now able to carry on the work of my

farm.

I would cheerfully recommend all persons requiring medical or surgical

aid to consult you at the earliest possible opportunity, as I know by

personal experience that the facilities cannot be surpassed for

treatment of all classes of chronic diseases.

Most gratefully yours,

J.D. PARKS,

Homer, Logan Co., Ky.

P.S.--I have always recommended my neighbors to your Institution and was

the cause of F.M. Brasher taking treatment, who was cured after two

doctors gave him up. J.D.P.

CASE 820,426. COMPLICATION OF DISEASES. A GRATEFUL PATIENT'S WORDS OF

PRAISE.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

[Illustration: William Henkel, Esq.]

Gentlemen--Having been in your Institution as a sufferer from two

distinct chronic diseases of years' standing, and having been placed

under the charge of your specialists, I was speedily relieved of my

afflictions. The Invalids' Hotel is a place as much like home as it is

possible for such an institution to be. The physicians and surgeons are

all expert specialists and thoroughly efficient; the nurses are very

competent, attentive and kind; and, in fact, the whole _personnel_ of

the Invalids' Hotel endeavor to do their best to make the patients feel

like being at home. I always felt while there as if I was one of the

family. I gladly recommend your Institution to all persons who are

afflicted with any kind of chronic disease, for from my own experience I

_know_ the professional staff will do all which they promise to do.

Please accept my thanks for the speedy benefits and perfect cure of my

diseases, and I think your Institution is worthy of the highest

endorsement.

Yours truly,

WILLIAM HENKEL,

No. 1917 Congress Street, St. Louis, Mo.

"_A question of life or death!_"

CASE 2A-107. STONE IN BLADDER. CASE SIMILAR TO THAT OF COL. ELLIOTT F.

SHEPARD, WHO DIED IN NEW YORK WHILE UNDERGOING AN OPERATION.

[Illustration: David S. Clark, Esq.]

_Gentlemen_--I am seventy-seven years of age and have resided in Erie

for sixty-two years, and for thirty-six years have been an elder in the

First Presbyterian Church. During four or five years I suffered from a

painful affection of the bladder; the severity permitted neither freedom

from pain by day nor calm repose by night. Meanwhile, I consulted

leading physicians and visited numerous health resorts. Neither time,

means nor effort were spared that I might be free from pain. Relief came

unexpectedly. A signal act of Providence, that should be acknowledged

daily, brought your Institution to my notice, though I had then no

acquaintance with any one connected with it. With me it was a question

of life or death. Up to last March I was in a condition of unendurable

torture. I knew that at my age, after the months of pain already borne,

that any operation would be serious, perhaps fatal. Accordingly, I

arranged my temporal affairs and carefully "set my house in order." On

the 13th of March last, I started for Buffalo to your Institution. Still

uninformed as to the cause of my trouble, I submitted to a searching

examination, as to my habits, constitution, parentage, the age and cause

of death of my parents, and other facts, from which a tolerable

biography could have been prepared. All was kindly intended. Their aim

was to locate my ailment and then to determine my ability to undergo an

operation. Having found a stone in the bladder, they advised that it be

crushed and extracted. By a strange coincidence as this was announced, I

learned of Col. Elliott F. Shepard's death under an operation for the

same disease. He was many years my junior, and seemingly far better able

to undergo the operation. Still, in my desperation, I determined to go

on. During five days, I was under treatment for the coming operation. On

the 18th of March the stone was crushed and extracted. It was a complete

success. Of the consideration, tenderness and skill of the surgeon and

his assistants, I cannot too strongly speak. Of the gentle and assiduous

nurses, the system and completeness of the whole establishment, as it

moved along as one harmonious whole, in all its departments, I cannot

sufficiently express my admiration. I am now relieved of a state of

torture, and restored to health and happiness equal to any period of my

life. This I say with sincerity and emphasis. Since then I have gained

twenty-two pounds in flesh. I wish my words could reach the ear of every

one similarly affected, throughout our land, to banish all doubts and

take advantage of the science, skill and pleasant surroundings so

happily blended in your Institution, for the removal of pain and the

mitigation of distress.

DAVID S. CLARK, Erie, Pa.

CASE 520,123. STONE IN BLADDER. 1200 GRAINS OF STONE REMOVED WITHOUT

CUTTING. PASSED BLOOD IN GREAT QUANTITIES FROM THE BLADDER. DOCTORS AT

HOME (AS USUAL) DISCOURAGED HIM FROM COMING TO US.

WORLD'S DISPENSARY MEDICAL ASSOCIATION:

[Illustration: James Vine, Esq.]

_Gentlemen_--I am glad to make public the wonderful cure that you

accomplished in my case. For ten years I was a sick man, and during

three years I suffered so much that life was a burden. My business had

to be given up and the torments were something that could not be

described. Every little while I had to urinate, and each time suffered a

spasm of pain, like a knife thrust; the use of a catheter was painful

and often it took long and painful trials before the water could be

drawn off. I passed blood, in quantities at times. When I went to your

place we had given up hope of a cure, and relief was all that I looked

for. My doctors at home discouraged me. I spent four weeks in your

Invalids' Hotel, and now at the age of sixty-seven years am sound and

hearty as any one, work from five in the morning until seven at night. I

manage a large and active business and enjoy life. I cannot express my

high praise of your Institution. Your doctors are skillful and the

nurses all kind and good. All understand their business and attend to

it. I came home a new man and cannot say enough for your praise, and to

express my thanks for the wonderful cure and comfort I have enjoyed.

Yours,

JAMBS VINE, SR.

P.S.--You removed a stone that weighed over 1200 grains from my bladder,

without cutting. The operation gave me complete relief. While there and

since, I have seen a great many skillful cures done by you.

J.V., SR., St. Catherines, Out.

CASE 620,610. STONE IN BLADDER--WEIGHT 530 GRAINS--SUCCESSFULLY REMOVED

WITHOUT CUTTING. NEIGHBORS TOLD HIM HE WOULD BE "BROUGHT HOME IN A BOX."

WORLD'S DISPENSARY MEDICAL ASSOCIATION:

[Illustration: C.A. CHURCH, ESQ.]