CAUSES. The immediate cause of leucorrhea is either congestion, or inflammation of the mucous membrane of the vagina or womb, or both. The exciting causes are numerous. Among others, deranged menstruation, prolonged nursing of children, pregnancy, abortions, excessive indulgence in sexual intercourse, uncleanliness, piles, uterine ulcers, and displacement of the womb, are the most common. In brief, it usually accompanies every uterine disorder which vitiates and reduces the system. During childhood, particularly in scrofulous children, discharges from the vagina are not unfrequent, owing to worms or other intestinal irritation.

Among the organic causes of leucorrhea, are ulceration of the mouth or neck of the womb and tumors. These will be considered hereafter.

TREATMENT. We have dwelt upon leucorrhea because of its prevalence and in order to exhibit the various forms it may assume. These reasons long ago prompted us to investigate it; and, ascertaining the derangement to consist in a relaxation of the walls of the vagina, attendant upon depressed vitality, for many years we experimented with various medicines to find those that would exercise specific properties in restoring the tissues involved to a natural condition, thereby arresting the abnormal discharge. Our efforts in that direction have been very successful, and our expectations more than realized. The treatment which we shall recommend is rational, based upon the pathological conditions of the disease, and has been attended with the greatest success.

It embraces the use of those general restoratives and specific uterine tonics, so harmoniously combined in Dr. Pierce's Favorite Prescription, a remedy which has achieved unparalleled success in the cure of this affection and won the highest praise from thousands of grateful women. It many cases, it is well to accompany its use with alterative treatment, for which the "Golden Medical Discovery" will be found especially effective. It is an absurd practice to arrest the discharge with astringent injections alone. The weak and lax walls of the vagina, as well as the other tissues of the system, require strength, and this can be gained only by the use of general and special tonics. Appropriate injections as auxiliary treatment will very much assist in the cure. The "Favorite Prescription" is a special tonic for the affected parts, and the "Golden Medical Discovery" is the best general alterative of which we have any knowledge. They may be taken in alternate doses every day. If the patient is very pale and anaemic, one drachm of the carbonate, or two drachms of the citrate or pyrophosphate of iron, may be advantageously added to each bottle of the "Favorite Prescription." If the carbonate be employed, as it is insoluble, the bottle should be well shaken every time before using. The functions of the skin should be kept active by frequent baths, and the patient, if able, should walk or ride in the open air, and freely expose herself to the sunshine. If the invalid be too weak to exercise much, she should go out in warm weather and sit in the open air. Sunshine is no less important in maintaining animal, than in supporting vegetable growth and health. The human being, like the plant, sickens and grows pale, weak and tender, if secluded from the sunlight. The apartments occupied should be thoroughly ventilated. Many women are sickly and feeble because they live in badly ventilated rooms.

We cannot too strongly urge in this, as in all other chronic diseases peculiar to women, that the bowels be kept regular. Frequent, but small doses of Dr. Pierce's Pleasant Pellets will prove most beneficial. If the vaginal passage is tender and irritable, an infusion, or tea of slippery-elm bark is very soothing, and may be used freely with a vaginal syringe. Whatever injection is employed, should be preceded by the free use of Castile soap and warm water, to thoroughly cleanse the parts. One part of glycerine to six parts of water is a soothing lotion when there is much tenderness, heat, and pain in the vagina. If there be no great tenderness in the vagina, or if the acute, inflammatory symptoms have yielded to the lotions already suggested, then a tonic and astringent injection should be employed.

For this purpose a wash made by dissolving one of DR. PIERCE'S PURIFYING AND STRENGTHENING LOTION TABLETS, in one pint of hot water is a superior application and will not fail to be of great benefit in controlling the disagreeable drain. If your medicine dealer is not supplied with these, mail 25 cents in one-cent stamps to us and we will forward a box of the Lotion Tablets by return post.

These Lotion Tablets have for many years been used in the treatment of obstinate cases of leucorrhea at the Invalids' Hotel and Surgical Institute, and their efficiency has been alike gratifying to both patient and physician.

If pruritus or severe itching, be also a symptom, the itching will readily yield if the parts be cleansed with Castile or other fine soap and warm water, followed by the application of a compound composed of two ounces of glycerine, one ounce of rose-water, and one drachm of sulphite of soda; or, for the sulphite of soda, two drachms of borax may be substituted. The following lotion is a good one to relieve pruritus: sugar of lead, two drachms; carbolic acid, half a drachm; laudanum, four ounces; glycerine, four ounces; water, four pints; mix. This may be applied to the itching parts, and also injected into the vagina.



HOW TO USE VAGINAL INJECTIONS. We usually recommend the Fountain Syringe illustrated in Fig. 6, as the most convenient instrument for administering vaginal injections. The fountains supplied by us are of soft rubber, and have extra nozzles, with which to make rectal, nasal or ear irrigations. There is also a large, long nozzle for vaginal injections.



It is channeled so is to permit the free clearing away of the secretions as the Douche is employed. The Fountain Syringe can he used without assistance, the flow of fluid is gradual, and with a force that can be varied, by raising or lowering the reservoir, yet is never so great as to be liable to produce injurious effects.

The syringes usually sold with small nozzles or pipes are of little or no value for vaginal injections. In many instances so small a tube will pass readily into the canal of the uterus, and hence there has frequently resulted an injection of a portion of the fluid into the uterus itself, producing severe pain. It is important, therefore, in using the Vaginal Douche to employ only a large tube that has grooves in its surface for the free clearing away of the fluid as it runs from the fountain.

Where it is desired to obtain relief from a congested, inflamed or sensitive and irritable state of the mucous surface, the employment of a large quantity of water as hot as it can be borne, is of the greatest remedial value. It rapidly diminishes the size of the blood vessels, and aids in bringing about a normal circulation in the parts.

As a rule, in taking the Douche with the Fountain Syringe the rubber bag is filled, and suspended from a nail or hook at a height of from two to five feet above the patient, and the fluid passes through the tube by force of gravity, thus requiring no muscular exercise. The force of the stream depends upon the height of the fountain above the outlet nozzle. It is only necessary that the patient should assume a comfortable position where the fluid which comes from the vaginal canal can flow into a water closet, or any convenient vessel.

After a thorough cleansing of the vaginal surfaces of mucus, by means of the warm or hot water, it is sometimes advisable to inject remedial fluids. These injections may readily be made with the fountain or bulb syringe, introducing not less than from two to four ounces. This may be retained sufficiently long to exert its remedial effects upon the mucous surface, which usually takes from five to eight minutes. The hips should be elevated, and the nozzle of the syringe surrounded by a napkin or other similar material, upon which moderate compression can be made so as to retain the fluid in the vagina for the necessary period.

When suffering from any uterine trouble, it is necessary to avoid severe fatigue. The amount and character of exercise should be suited to the condition of the patient; while, most important of all, the strictest abstinence from sexual intercourse should be observed.

To those who are unable readily to obtain the Fountain Syringe above recommended we can send by mail, post-paid, one of these instruments on receipt of $2.00.

A Soft Rubber-bulb, or Pump Syringe (illustrated in Fig. 7), not so good for making vaginal injections, can be sent by us, post-paid, for from 75cts. to $1.50, the price varying with the quality and size.

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STERILITY.

(BARRENNESS.)

Real sentiment and interest center in fecundity, since the desires and happiness of mankind are consummated in marriage and procreation. How dreary would life be without love, companionship, and the family! How precious are the ties that bind our hearts to father, mother, daughter, and son! The love of children is innate in the heart of every true man and woman. Each child born supplements the lives of its parents with new interest, awakens tender concern, and unites their sympathies with its young life.

How dreary is the thought that one may attain a ripe old age with neither son nor daughter to smooth the decline of life, or sorrow for his or her departure! How many women desire a first-born of love, the idol of their waiting hearts, a soul, which shall be begotten within, clothed with their own nature, and yet immortal! It is a natural instinct, this yearning of the heart for offspring; and yet little is said upon this subject, in which so much is experienced. All that is beautiful and lovely in woman, finds its climax in motherhood. What earthly being do we love so devotedly as our mother?



Men and women exhibit but little concern, mere idle curiosity, perhaps, on this subject, unless, perchance, there is no evidence of their own reproductive powers. If, however, these appear to be deficient, then few topics are more deeply interesting or investigated with greater personal solicitude. Such persons will seldom submit their condition to the family physician, for it is a delicate subject, involving personal considerations, and, therefor, they prefer to consult with one who cannot connect their unfortunate situation with any of the incidents which enter into the history of their lives. This is very natural, and sometimes is the only way to keep private matters profoundly secret. Being widely known as specialists, devoting our undivided attention to chronic affections, and having unusual facilities for the investigation and management of such cases, we have been applied to in innumerable instances, to ascertain the causes of barrenness and effect its removal.

It is admitted that the question of a woman's sterility is practically decided in the first three years of married life, for statistics show that less than ten out of a hundred women who do not indicate their fertility in the first three years of wedlock ever bear children. We have treated many who gave no evidence of fertility for a much longer period of married life, and who afterwards gave birth to children. We are unable to state the proper ratio of the number of the married who are childless; much less have we the right to assume that all who decline the responsibilities of motherhood are necessarily barren.

CAUSES. The causes of barrenness may be obliteration of the canal of the neck of the womb, sealing up of its mouth, or inflammation resulting in adhesion of the walls of the vagina, thus obstructing the passage to the uterus. In the latter case, the vagina forms a short, closed sac. In some instances, the vaginal passage cannot be entered in consequence of an imperforate hymen. Again, the cause of barrenness may either be a diseased condition of the ovaries, preventing them from maturing healthy germs, or chronic inflammation of the mucous membrane of the neck of the uterus, which does not render conception impossible, but improbable. It is one of the most common causes of unfruitfulness, because the female seldom, if ever, recovers from it spontaneously. It has been known to exist for twenty or thirty years.

Chronic inflammation of the vagina also gives rise to acrid secretions, which destroy the vitality of the spermatozoa. Suppression of the menses, or any disorder of the uterine functions, may disqualify the female for reproduction. Flexions of the uterus, displacements, congestions, and local debility, may likewise prevent fertility. Sterility may result from impaired ovarian innervation or undue excitement of the nerves, either of which deranges the process of ovulation. Even too frequent indulgence in marital pleasures sometimes defeats conception. Prostitutes who indulge in excessive and promiscuous sexual intercourse, seldom become pregnant. Any thing that enfeebles the functional powers of the system is liable to disqualify the female for reproduction.

TREATMENT. An extensive observation and experience in the treatment of sterility, convinces us that, in the majority of cases, barrenness is due to some form of disease which can be easily remedied. If the passages through the neck of the uterus be closed or contracted, and this is the most frequent cause of sterility, a very delicate surgical operation, which causes little if any pain or inconvenience to the patient, will remove the impediment to fertility. In many of these cases, we have succeeded in removing the contraction and stricture of the neck of the womb by dilatation. When the vaginal walls are so firmly united as to prevent copulation, a surgical operation may be necessary to overcome their adhesion. When the hymen obstructs the vaginal orifice, a similar operation may be necessary to divide it. Vaginismus, which will be treated elsewhere, sometimes causes sterility.

It is proper that we should suggest to the barren, that if sexual intercourse be indulged in only very abstemiously, conception will be more likely to occur than if moderation be not exercised. We may also very properly allude to the fact that there is greater aptitude to fecundation immediately before and soon after the menstrual periods than at other times. In fact, many medical men believe that it is impossible for conception to occur from the twelfth day following menstruation up to within two or three days of the return of the menses.

ELONGATION OF THE NECK OF THE WOMB. An elongated condition of the neck of the womb, illustrated by Fig. 9, is frequently a cause of sterility. If this part is elongated, slim and pointed, as shown in the illustration, it is apt to curve or bend upon itself, thus constricting the passage through it and preventing the transit of seminal fluid into the womb. An eminent author says, "Even a slight degree of elongation, in which the cervix, or neck, has a conical shape, has been observed to be frequently followed by that condition [sterility]." Our own observations, embracing the examination of hundreds of sterile women annually, lead us to believe that this condition is among the common causes of barrenness. But, fortunately, it is one of those most easily overcome.



TREATMENT. If the neck is only slightly elongated, this consists in dividing the slim projecting part, by the use of the hysterotome, If it be a more aggravated case, a portion of the womb must be removed. This operation is perfectly safe and simple, and, strange as it may seem to those who are not familiar with operations upon the womb, is not painful. We have never seen any bad results follow it, but have known it to be the means of rendering numerous barren women fruitful.



FLEXIONS AND VERSIONS OF THE WOMB. Flexion of the uterus, in which it is bent upon itself, as illustrated in Fig. 10, produces a bending of the cervical canal, constricting or obliterating it, and thus preventing the passage of spermatozoa through it. Version of the uterus in which its top, or fundus, falls either forward against the bladder (anteversion), as illustrated in Fig. 11, or backward against the rectum (retroversion), may close the mouth of the uterus by firmly pressing it against the wall of the vaginal canal, and thus prevent the passage of spermatozoa into the womb. 'The treatment of these several displacements will be considered hereafter. We may here remark, however, that they can be remedied by proper treatment. Our mechanical movements, manipulations, and kneadings are invaluable aids in correcting these displacements.

DISEASE OF THE OVARIES. Sterility may be due to disease of the ovaries. Chronic inflammation of the ovaries may result from uterine disorders or peritonitis, and is commonly attended with a sense of fullness and tenderness, and pain in the ovarian region. These symptoms are more apparent upon slight pressure, or during menstruation. This disease is curable, although it may require considerable time to perfectly restore the health. When this chronic affection is the result of other derangements, the indications are to restore health in the contiguous organs, and to relieve excessive congestion and nervous excitement in the ovaries. The patient should be very quiet during the menstrual period and avoid severe exercise or fatiguing occupations, not only at those periods, but during the intervals. All measures calculated to improve the general health should be adopted. Use injections of warm water, medicated with borax, soda, and glycerine, in the vagina every night and morning. The surface of the body should be kept clean by the daily employment of hand-baths, followed by brisk friction. The bowels, if constipated, should be regulated as suggested for constipation. The system should be strengthened by Dr. Pierce's Favorite Prescription, and, if the blood be disordered, no better alterative can be found for domestic use than Dr. Pierce's Golden Medical Discovery. If the patient does not in a few months improve under this treatment, the case should be placed under the immediate care of some physician well qualified by education and experience to critically examine and successfully treat this affection.

CHRONIC INFLAMMATION AND ULCERATION OF THE UTERUS, A CAUSE OF STERILITY. When enumerating the causes of barrenness we mentioned that chronic inflammation of the mucous membrane of the mouth and neck of the womb was the most common affection that defeats conception. Of all diseases of female organs, this is, without doubt, the most common, and, since it does not at first produce great inconvenience or immediately endanger life, it does not excite the attention which its importance demands. It is overlooked, and, when the attention is directed to the existence of this long-neglected disease it appears so trivial that it is not regarded as being the real cause of infertility in the patient.

When this disease has existed for a long time, the very structure of the parts involved becomes changed. The glands of the cervical membrane secrete a glairy mucus, resembling the white, or albuminous part of an egg. The secretion is thick and ropy, and fills the entire mouth and neck of the uterus, thus preventing the entrance of the spermatozoa. The mucous membrane becomes thickened, the inflammation extends to the deeper structures, and, on examination through the speculum, we find the mouth of the uterus inflamed, hardened, and enlarged, as represented in Fig. 22, Colored Plate IV, or in Fig. 23 of same plate. Fig. 25, Plate IV, shows the mucous follicles just as they are found all along the neck of the womb, in a state of inflammation and enlargement, and filled with a fluid resembling honey, giving rise to ulceration and a thick discharge, as illustrated in Fig. 23, Colored Plate IV.

Feebleness of the constitution, impoverishment of the blood, a scrofulous diathesis, want of exercise, uncleanliness, tight lacing, disappointment, excessive excitement of the passions, the use of pessaries for displacement of the uterus, overwork, and taking cold, all predispose the cervical membrane to chronic ulceration.

The inflammation may be so mild, and the discharge so trifling in quantity, as scarcely to attract attention. But after it obtains a firmer hold, and, in most cases, it is aggravated by exposure or neglect, the patient experiences dragging sensations about the pelvis, and pain in back and loins, accompanied with a bearing-down sensation and numbness or pain extending to the thighs.

The discharge is thick, starch-like, and generally irritating. The patient becomes irascible, capricious, querulous, and sometimes moody and hysterical. She is easily discouraged, her appetite and digestion become impaired, and she grows thin and does not look or act as when in health.

TREATMENT. In offering a few hints for the domestic management of these abnormal conditions, we would at the same time remark, that, while health may be regained by skillful treatment, recovery will be gradual. We especially wish to guard the patient against entertaining too strong expectations of a speedy recovery. Although she may employ the best treatment known, yet from three to five months may elapse before a perfect cure can be effected. In persons of scrofulous diathesis, in whom the recuperative forces are weakened, it is very difficult to effect a radical cure. It is equally true, however, that under domestic management alone, thousands have been restored to perfect health and fruitfulness.

Hygienic management consists in toning the functions of the skin by daily bathing the surface of the body, and quickening the circulation by brisk friction. The patient should rise early in the morning, and exercise in the fresh and invigorating air. Those who sleep in warm rooms, or spend much of their time in bed, will continue to have congestion of the uterus, and habitual discharges from this enfeebled organ. The patient should take daily walks, increasing the length of the excursion from time to time, but not to the extent of producing fatigue. The bowels, if constipated, should be regulated. Strengthen the system by using Dr. Pierce's Favorite Prescription, to each bottle of which add two drachms of citrate or pyrophosphate of iron. The mouth and neck of the uterus should be thoroughly cleansed by the use of the syringe, as suggested for the treatment of leucorrhea. The use of the solution of Dr. Pierce's Purifying and Strengthening Lotion Tablets there advised will also be beneficial, if thoroughly applied.

A most valuable course of local treatment, which may be adopted by any intelligent lady without the aid of a physician, and one that will result in the greatest benefit when there is morbid sensibility, congestion, inflammation, or ulceration about the mouth or neck of the womb, consists in applying to those parts a roll of medicated cotton or soft sponge, allowing it to remain there for twelve hours at a time. A piece of fine, soft, compressible sponge, as large as a hen's egg, or a roll of cotton batting of two-thirds that size, is thoroughly saturated with pure glycerine. Securely fasten to it a stout cord a few inches long. The vagina and affected parts having been thoroughly cleansed with warm water and Castile soap, as advised in the treatment of leucorrhea, the sponge or cotton should be passed up the vagina with the finger, and pressed rather firmly against the mouth and neck of the womb, which, being enlarged, and, consequently falling below its natural position, will generally be low down in the vagina, and so hardened as to be unmistakably distinguished from the surrounding parts by the sense of touch. The glycerine, having a very strong affinity for water, will absorb large quantities of the serum, which has been effused into the affected tissues in consequence of their congestion and inflammation, and thus reduce the inflammation and enlargement. This is the cause of the profuse, watery discharge which follows the application. In twelve hours after the sponge or cotton has been applied, it should be removed by means of the attached thread, one end of which has been purposely left hanging out of the vagina. Then thoroughly cleanse the vagina with warm water, use the solution of Dr. Pierce's Lotion Tablets as suggested for the treatment of leucorrhea, and repeat the glycerine application the following day or every other day.

If there is no irritation or tenderness of the vagina, add one drachm of tincture of iodine to each ounce of the glycerine, alternating the use of this with that of pure glycerine; or, the iodine and glycerine may be used every third day, and the glycerine alone on the two intervening days. As the iodine will color the finger somewhat, it is well to know that this unpleasant effect may be almost or entirely avoided by coating that member with lard, sweet oil, or vaseline. The stain may be readily removed with a solution of iodide of potassium. The use of Dr. Pierce's Antiseptic and Healing Suppositories as advised on an other page under the head of Ulceration of the Uterus will aid greatly in effecting a cure.

If your medicine dealer does not have these Suppositories in stock, mail 25 cents in stamps to Dr. R.V. Pierce, Buffalo, N.Y., and a box will be sent you by return post.

It is well to alternate Dr. Pierce's Golden Medical Discovery with Dr. Pierce's Favorite Prescription, taking of each three times a day. By persevering in this course of treatment, nine-tenths of those who are thus afflicted will improve and be fully restored to health, fruitfulness and happiness. If barrenness continue, the case should be unreservedly submitted, either in person or by letter, to a physician skilled in the diagnosis and treatment of these affections.

From the foregoing remarks, the reader will perceive that there are a variety of diseased conditions, any one of which may produce sterility. It is equally true that nearly all these conditions may be easily cured by proper medical or surgical treatment. A frequent cause of barrenness is stricture of the neck of the uterus. No medicine that a woman can take or have applied will remove this unnatural condition. Fortunately, however, the means to be employed cause no pain, are perfectly safe, and the time required to effect a cure is short, rarely over twenty or thirty days.

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DISPLACEMENTS OF THE WOMB.

The relative positions of the womb and surrounding organs, when in a state of health, are well illustrated by Fig. 1, page 680. The womb is supported in its place by resting upon the vaginal walls, and by a broad ligament on either side, as well as by other connective tissues. By general debility of the system, the supports of the womb, like the other tissues of the body, become weakened and inadequate to perfectly perform their duty, thus permitting various displacements of that organ.

PROLAPSUS, OR FALLING OF THE UTERUS, is a common form of displacement. It has been erroneously regarded as a local uterine disease, requiring only local treatment instead of being considered as a symptom of general derangement, and, therefore, requiring constitutional treatment. Hence, variously devised supporters have been invented to retain the womb in position after its replacement. It is a law of physiology, that the muscular system is strengthened by use, and that want of exercise weakens it. The blacksmith's arm is strengthened and developed by daily exercise. Support his arm in a sling, and the muscles will be greatly weakened and wasted. So when artificial supports are used to retain the womb in position, thereby relieving the supporting ligaments and tissues of their normal function, the natural supports of the uterus are still further weakened, and the prolapsus will be worse than before when the artificial support is removed. Besides, all these mechanical contrivances are irritating to the tissues of the womb and vagina, and frequently produce congestion, inflammation, and even ulceration, thus rendering the patient's condition much worse than before their employment. These worse than useless appliances should never be resorted to for the temporary relief which they sometimes afford. Constitutional treatment together with appropriate applications is the only effectual method of remedying this morbid condition.

SYMPTOMS. When the displacement is sufficient to cause any serious disturbance, the prominent symptoms are a sensation of dragging and weight in the region of the womb, pain in the back and loins, inability to lift weights, great fatigue from walking, leucorrhea, a frequent desire to urinate, irritation of the lower bowel, and derangement of the stomach. The womb may protrude from the vaginal orifice; in very rare cases, wholly protrudes, and may be inverted.

CAUSES. As we have already stated, general debility favors prolapsus of the womb, but various general and local circumstances and conditions also favor its occurrence. Wearing heavy garments supported only by the hips, compressing the waist and abdomen with tight clothing, thus forcing the abdominal organs down upon the womb, are fruitful causes of this affection. Excesses in sexual intercourse give rise to leucorrhea, producing a relaxed condition of the vagina, upon which the womb rests, and, in this way, one of its supports is weakened. Enlargement of the uterus from congestion, and inflammation or tumors also favor prolapsus. Abortion may leave the womb enlarged, its supports weakened, and result in this displacement.



FLEXIONS AND VERSIONS. Instead of sliding down into the vagina, as in prolapsus, the uterus is liable to fall or be forced into other unnatural positions. When the uterus is bent upon itself, it is called flexion. If the bending is backward, it is called retroflexion; if forward, anteflexion. Fig. 12, represents the former condition, the uterus being flexed backward so that the fundus, or upper part of the womb, is pressed against the rectum, while the neck of the uterus remains in its natural position. This is a common form of displacement, and generally occurs between the ages of fourteen and fifty.

SYMPTOMS. The prominent symptoms of retroflexion of the uterus are a sense of weight in the region of the rectum, difficulty in evacuating the bowels, and, sometimes a retention of the feces. There may be suppression of the urine and the menses may be diminished in quantity. If retroflexion is due to a chronic enlargement of the uterus, caused by abortion or parturition, the patient suffers from an immoderate menstrual flow.

CAUSES. The principal causes of retroflexion are congestion, enlargement and tumors of the uterus. Congestion is liable to occur in women possessing an extremely active temperament, as well as in those of sedentary and indolent habits. Retroflexion is a common displacement in both married and unmarried women; it is a secondary affection, and, when it is caused by congestion, the menses are painful and reduced in quantity, and there is pain in the back and a sense of weight in the region of the rectum. In some instances, there is a reflex irritation of the mammary glands, and a consequent secretion of milk. There may also be nausea and vomiting, which often lead to the erroneous opinion that the patient is pregnant.

Anteflexion of the uterus denotes a bending forward of the body and fundus of the uterus, while the neck remains in its natural position.

In versions of the uterus, neither the body nor the neck of the womb is bent upon itself, but the whole organ is completely turned backward or forward.



Retroversion of the uterus, illustrated by Fig. 13, signifies a change in the position of the womb, so that the upper, or fundal portion of the organ drops back toward the concavity of the sacrum, while the neck preserves a straight line in the opposite direction. The fundus presses forcibly against the rectum, while the upper part of the vagina bends abruptly and forms an acute angle near the mouth of the uterus.

SYMPTOMS. Retroversion is indicated by bearing-down pains in the loins and difficulty in evacuating the bowels. The feces may accumulate in the rectum, because they cannot pass this obstruction.

CAUSES. Jumping, falling, or undue pressure from the contents of the abdomen, may suddenly cause retroversion of the uterus. Sometimes retroversion results from obstinate constipation.

Anteversion. This term designates another unnatural position of the uterus, in which the fundus, or upper part of the organ, falls forward, as illustrated by Fig. 14, while the neck points towards the hollow of the sacrum. This position of the womb is the reverse of that of retroversion. In its natural position, the fundus of the uterus is slightly inclined forward, and any pressure, or forward traction, is liable to cause it to fall still further in that direction.



SYMPTOMS. One of the most common symptoms of anteversion is a frequent desire to urinate, in consequence of the pressure of the uterus upon the bladder. The free flow of the menses is sometimes obstructed.

CAUSES. The causes are tight lacing, prolapse of the abdominal organs, weakness of the supporting ligaments, and enervating habits.

TREATMENT. In treating all the various displacements of the uterus, the prominent indication is to tone up the general system, for by so doing we also strengthen the uterine supports.

Digestion should be improved, the blood enriched, and nutrition increased, so that the muscles and ligaments which retain the womb in position may become firm and strong. The womb will thus be gradually drawn into position by their normal action and firmly supported. It is a great mistake, made by physicians as well as patients, to consider a displacement of the uterus a local disease, requiring only local treatment. A restoration of the general health will result in the cure of these displacements, the uterus will regain its tone and muscular power, and the local derangement, with its attendant pain and morbid symptoms, will disappear.

It is true that displacements of the womb may be associated with inflammation and ulcers, which require local treatment, as elsewhere suggested; but simple displacement of the uterus may be remedied by pursuing the following course of sanitary and medical treatment. Sleep on a hard bed, rise early, bathe, and take a short walk before breakfast. Dress the body warmly and allow sufficient space for the easy and full expansion of the lungs. Eat moderately three meals a day, of those articles which are nutritious and readily digested. Keep the bowels regular by the use of proper food. If they are constipated, use Dr. Pierce's Pellets to keep them open and regular. Avoid retaining the standing position too long at a time, especially when the symptoms are aggravated by it. Many energetic women disregard their increasing pains, and keep upon their feet as long as possible. Such a course is extremely injurious and should be avoided.

As a general restorative and uterine tonic, nothing surpasses Dr. Pierce's Favorite Prescription, which is sold by druggists and accompanied with full directions for use. If leucorrhea is an attendant symptom, the treatment suggested for that condition should be employed. The use of Dr. Pierce's Antiseptic and Healing Suppositories, applying one every third night After having first cleansed the vagina and neck of the womb thoroughly by the use of warm water and soap as an injection, will prove of great benefit in giving strength to the supports of the womb and its appendages.



By persevering in the rational treatment which we have suggested for the various displacements of the womb, nearly all who suffer from such derangements may be fully restored to health. The patient should not expect speedy relief. Considerable time will be necessary to bring the general system up to a perfect standard of health, and, until this is accomplished, no great improvement in the distressing symptoms can be expected. Mechanical movements are especially effective in this class of cases. We have successfully treated many obstinate cases in which the displacements were very serious.

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ULCERATION OF THE UTERUS.

Ulceration is the process by which ulcers, or sores, are produced. It is characterized by the secretion of pus or some fetid discharge, and is continued as a local disease through the operation of constitutional causes. Ulcers are generally symptoms of other morbid conditions.

Ulcers may form in the mouth or neck of the uterus, and, omitting cancerous ulcers and those of a syphilitic character, which are considered elsewhere, may be classified as Granular and Follicular.



GRANULAR ULCER. This variety of ulcerative degeneration is the most frequent, and may exist for some time without exciting any suspicion in the mind of the patient that she is afflicted with any such morbid condition. There is local inflammation, and the mouth of the uterus is uneven, rough, and granular. If an examination be made with the speculum, the mouth of the uterus is often found in the condition represented in Fig. 22, Colored Plate IV.

Figs 15 and 16 represent two different forms of specula. The one represented by Fig. 15 consists of a tube of glass coated with quicksilver and covered with India rubber, which is thoroughly varnished. That represented by Fig. 18 is made of metal and plated. By using one of these instruments, the condition of the mouth of the womb can be distinctly seen.



FOLLICULAR ULCER. When the mucous follicles of the neck of the uterus are inflamed they enlarge and become filled with a fluid having the color and consistency of honey, presenting the appearance illustrated by Fig. 25, Colored Plato IV. This secretion, because of the presence of the Inflammation, is not discharged. The follicles, therefore, continue to enlarge until they burst, and we then see in their place the red, elevated, angry-looking eminence, which is called a follicular ulcer.

SYMPTOMS. The severity of the symptoms depends upon the character of the ulceration. It may be simple or associated with purulent leucorrhea and hemorrhage. If ulceration be slight and local, few symptoms will be present; but if it be associated with uterine debility, congestion and inflammation of the mucous membrane of the uterus, the discharge will be profuse, and there will be fixed pain in the back and loins, a bearing-down sensation, and great difficulty in walking. The discharge is weakening, as it impoverishes the blood, and thus reduces the strength.

CAUSES. Ulceration may be induced by any thing that excites inflammation of the lining membrane of the mouth and neck of the uterus. The use of pessaries, excessive sexual indulgence, injuries occasioned by giving birth to children, congestions, enlargements and displacements, may all operate as causes.

TREATMENT. We cannot too strongly condemn the practice so popular at the present time with physicians generally, of indiscriminately burning all uterine ulcers with strong caustics, such as nitrate of silver, chromate of potassium, and other similar escharotics, regardless of the condition of the general system. Ulcers of the womb must be healed in the same manner as those upon any other part of the body. It is an irrational practice to repeatedly cauterize them, expecting thereby to promote healing, while the system is vitiated and the vitality far below the standard of health. Enrich the blood, tone up the system, keep the ulcers cleansed by the frequent use of lotions, and they will generally heal. Caustics often aggravate the irritability and interfere with the healing processes of nature. Ladies should not unnecessarily submit to the exposure of their persons. If they perseveringly employ the treatment which we shall suggest, other local treatment will very rarely be found necessary. This modern warfare which physicians are waging upon the unoffending womb is a most irrational practice. Our grandmothers got along very well without exposing themselves to the humiliation and tortures of this new-born empiricism. We do not wish to be understood as undervaluing or denying the necessity, in rare cases, of examinations of the uterus, or as being unappreciative of the aid afforded in such investigations by the speculum, and the beneficial effects of local applications made directly to the womb through that instrument. What we affirm is, that such examinations and applications are, in the practice of most modern physicians, made unnecessarily frequent, resulting many times in lasting injury to the patient.

GENERAL MEANS. As has already been indicated, constitutional treatment should be principally relied upon to cure ulceration of the neck of the womb. Put the system in perfect order and the local ulceration cannot fail to heal. If you have a sore or ulcer upon the leg you very naturally reason that there is a fault in the system at large or in the blood. You do not apply caustics to the sore, but you go to work to restore the blood and system to a normal or healthy condition and as soon as this is accomplished the open and rebellious sore, or ulcer, heals of its own accord. All you have to do locally, to stimulate the ulcer to heal, is to keep it well cleansed by the use of Castile soap and warm water. Just so with ulceration of the womb. Thoroughly cleanse the vagina and neck of the womb once a day by the use of warm water and a little soap, applying this thoroughly, as directed on page 704, under the head of treatment for leucorrhea, and using a solution of Dr. Pierce's Purifying and Strengthening Lotion Tablets as there directed. After thus thoroughly cleansing and purifying the parts, a piece of soft sponge as large as a hen's egg, to which a bit of cord or strong thread is attached to facilitate removing it, may be thoroughly wet in pure glycerine and introduced into the vagina, pressed against the mouth of the womb, and allowed to remain there for twelve hours, when it should be gently removed by pulling on the attached string. The cleansing lotion of soap and warm water should be used daily and followed by the glycerine application.

Every third night instead of the glycerine tampon apply one of Dr. Pierce's Antiseptic and Healing Suppositories, pressing it well up against the mouth of the womb, and letting it remain there to slowly dissolve. This will give far better curative results than the application of nitrate of silver or other caustics so generally used by physicians. Besides it has the great advantage of being entirely harmless in any condition of the parts to which it is applied. These Suppositories are powerfully antiseptic, destroying all offensive odors and have a soothing and at the same time tonic or strengthening effect upon the neck of the womb and the vagina.

In cases where there is prolapsus or falling of the womb, or Anteversion or Retroversion, or other displacements the use of the Antiseptic and Healing Suppositories will be found to be of great benefit in giving strength to the supports of the womb and its appendages.

If your dealer is not supplied with the Suppositories, inclose 25 cents in one-cent stamps to us at Buffalo, N.Y., and a package will be sent you, post-paid.

We are fully aware that this thorough and systematic course of treatment is slightly troublesome in its application, but what system of treatment that can promise similar success is not?

This course of treatment must be rigidly adhered to for several weeks before we can expect a complete cure of the ulcers and the arrest of the consequent leucorrheal discharge.

THE SHEET ANCHOR OF HOPE. Do not fail to bear in mind that no difference how good the lotions and other local applications may be, your chief reliance in all cases of ulceration of the womb, as well as in those of simple leucorrhea, must be upon thorough constitutional treatment. To this end Dr. Pierce's Golden Medical Discovery should be taken three times a day in doses of from one to one-and-a-half teaspoonfuls one hour before each meal, and in the middle of the forenoon, in the middle of the afternoon, and just before retiring for the night, a like amount of Dr. Pierce's Favorite Prescription should be taken. The use of these blood cleansing and invigorating tonic medicines should be kept up persistently for several weeks; for you must not expect a perfect cure too soon in a malady that has become chronic and seated. The disease does not become established hastily, but is slow in its inception and progress, and will only gradually and slowly yield to the best of treatment, which we believe we have already pointed out. Followed earnestly, faithfully and persistently, the use of the means which we have suggested will rarely, if ever, fail.

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URINARY FISTULA.

A fistula, or false passage, is sometimes formed between the bladder and the vagina, between the bladder and the uterus, or between the urethra and the vagina. This passage allows the urine to escape through it into the vagina, and is a source of great annoyance and suffering. This affection is most commonly due to sloughing, caused by severe and long-continued pressure upon the parts during child-labor. It is also sometimes produced by the unskillful use of forceps and other instruments employed by midwives. Syphilitic and other ulcerations may so destroy the tissues as to form a urinary fistula.

TREATMENT. The treatment is purely surgical, and consists in paring the edges of the opening so as to make them raw, bringing them together and holding the parts thus by means of stitches until they heal. By the aid of a speculum, properly curved scissors, needles with long handles, fine silver wire, and a few other instruments and appliances, the skillful surgeon can close a urinary fistula with almost as much ease as he can close a wound on the surface of the body.

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DISORDERS INCIDENT TO PREGNANCY.

While some women pass through the whole period of pregnancy without inconvenience, others suffer from various sympathetic disturbances, as "morning sickness," impaired appetite, constipation, diarrhea, headache, "heart-burn," fainting fits, difficult breathing, and sometimes convulsions. A strong nervous sympathy exists between the uterus and every part of the system and this sympathy is greatly intensified by pregnancy, causing the distressing symptoms above mentioned.

TREATMENT. By proper treatment, most of these evils can be obviated and the patient made comfortable. By the moderate use of such a nervine and uterine tonic as Dr. Pierce's Favorite Prescription, this nervous irritability may be controlled or subdued, and the disagreeable symptoms thus avoided.

While the female is pregnant, she should avoid all compression of the waist and abdomen. For this reason tight clothing, stays, or corsets must be discarded. She should also carefully regulate her diet, selecting that which is most nutritious and easily digested.

The nausea which occurs in the morning may generally be avoided by partaking of a little light food and a cup of tea or coffee before leaving the bed. If vomiting occurs, and the ejected matter be very acid, carbonate of magnesia, taken in tablespoonful doses, or some alkali with aromatics, or pulverized charcoal, which can be obtained at any drug store, will afford relief. If constipation or diarrhea be experienced, small doses of Dr. Pierce's Pellets should be employed—one or two only at a time. Want of appetite, headache, or a tendency to convulsions, can be generally overcome by a persistent use of Dr. Pierce's Favorite Prescription, which should be taken in teaspoonful doses three or four times each day. Indeed, this valuable medicine not only relieves the distressing symptoms which frequently attend the pregnant state, but also prepares the system for the ordeal of parturition (delivery). One or two bottles of this nervine and tonic used previous to confinement, will, in many cases, save hours of terrible suffering, besides regulating the system, and thus insuring a speedy recovery. We have received the heartfelt thanks of hundreds of grateful mothers for the inestimable benefit thus conferred. The Favorite Prescription is perfectly safe and harmless to use at all times and under all circumstances in the doses above prescribed.

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OVARIAN AND UTERINE TUMORS.

We have space only to give a brief outline of the characteristics and treatment of the most frequent classes of tumors which affect the ovaries and uterus.

OVARIAN TUMORS generally consist of one or more cysts or sacs, developed within the ovary, and filled with a fluid, or semi-fluid matter, which is formed in their interior. The cysts vary in size, in some instances being not larger than a pea, while in others they are capable of containing many quarts of fluid. In one case operated upon at the Invalids' Hotel and Surgical Institute, thirty-five pints of fluid were taken from three cysts.

The effect of ovarian tumors on the duration of life is shown by the statistics of Stafford Lee. Of 123 cases, nearly a third died within a year, more than one-half within two years from the first development of reliable symptoms, while only seventeen lived for nine years or upwards.

FIBROID TUMORS of the uterus are composed of fibrous tissue, identical in structure with that of the uterine walls. They are met with in all sizes, from that of a small shot to that of a mass capable of filling the entire cavity of the abdomen. Cases are on record in which these tumors have attained the weight of seventy pounds.

The manner in which fibroid tumors terminate life is generally by prostration and debility produced by pressure on, and consequently, interference with, the function of some one or more of the organs essential to life; or by anaemia and debility, produced by the severe hemorrhages, which the intra-uterine or sub-mucous form not infrequently induces.

POLYPI OR POLYPOID TUMORS of the uterus are of three kinds, cystic, mucous and fibrous. They vary greatly in size, sometimes being as large as a tea-cup; and their point of attachment may be extensive or consist only of a small pedicle. The cystic and mucous varieties may spring from any portion of the mucous surface of the uterus, but they are more frequently met with growing from the mucous membrane lining the cervical canal, and pendent from the mouth of the womb, as represented in Fig. 21 and in Fig. 26, Colored Plate IV; while the fibrous variety generally grows from the sub-mucous tissue at or near the fundus, or upper portion, of the uterus.

The most prominent symptoms of polypoid growths are hemorrhage, which is almost invariably present, leucorrhea, pain, backache, and a sense of weight and dragging in the pelvis.

The best method of treatment, and, in fact, the only effectual one, is removal with the ecraseur, polypus forceps, or galvano-cautery. The operation is usually attended with little or no pain.

FOR MORE THAN TWENTY-FIVE YEARS the physicians of the Invalids' Hotel and Surgical Institute, have been successfully treating tumors by means of electricity. More recently, the medical profession has quite generally adopted electrical applications in response to the advice of Apostoli, of Paris. The plan used however is crude. It does not compare in results with the successful and safe procedure that our surgeons have invented and pursued.

Electrical treatment will destroy the life of ovarian and fibroid tumors if applied early and after the improved methods so long used at our Institution. The destructive effect of electricity is modified by the introduction of certain electro-chemical applications so that it attacks and kills only the cells of the tumor.

THE VERY LARGE OVARIAN TUMORS, however, are not amenable to treatment by this process. The walls of their cysts become so thin and weak, while the pressure of the fluid from within is so great, that sudden and spontaneous rupture is liable to occur at any time and produce death. Removal by a cutting operation is necessary in such cases. Fortunately this procedure, as skillfully modified and perfected by experience, has, in the hands of our surgeons, proven free from the dangers and hazard common to Ovariotomy. This is due to skillful operation and to the fact that in our Institution the sanitary arrangements are as perfect as it is possible to make them. Everything is at hand in the way of instruments and appliances likely to be required, and the entire procedure is conducted upon the principles of perfect cleanliness and antisepsis, which obviate the risk of inflammation and blood-poisoning.

Furthermore, our nurses have had such fine training and such a vast experience in their attendance upon such cases, that wants are anticipated, and details, that would escape those not so well qualified, are looked after so thoughtfully and vigilantly that the convalescence is rapid, as well as being in every way comfortable and safe. Under such conditions

OUR SURGEONS HAVE COMPLETED A LONG LIST OF REMOVALS OF OVARIAN TUMORS WITHOUT A SINGLE DEATH!

We are, therefore, warranted in stating that

THE DANGERS DUE TO THE PRESENCE OF THESE TUMORS ARE FAR GREATER THAN THE SLIGHT RISKS OF REMOVAL BY THE SKILLFUL METHODS EMPLOYED BY OUR SURGEONS.

Owing to a change made in the anaesthetic used, the painful and persistent vomiting that often follows abdominal operations is prevented. This does away with the greatest of all the dangers attendant upon the operation of Ovariotomy, and favors speedy recovery. Food, as administered in the form of artificially digested and concentrated nourishment, is readily retained. The strength is thus rapidly restored, and the healing process hastened.

It is generally supposed that the size of the opening made through the abdominal walls is large, proportionate to the size of these tumors. This is an error. Even in the largest cystic tumors where the development is immense, a small incision only, is made—simply sufficient to bring the walls of the tumor in view and admit, perhaps, two or three fingers. The tumor is then rapidly emptied of its contents by means of a powerful suction apparatus. Adhesions, if any exist, are then carefully removed, and hemorrhage therefrom prevented; after which the large sac of the tumor, which when collapsed is like a thin bag, is readily drawn out through the small opening in the abdomen and removed. The small pedicle or cord-like mass of vessels that supplies the tumor, are then carefully treated after a plan invented by, and peculiar to, ourselves, which effectually prevents any bleeding, and, at the same time, does not leave any irritating substance, such as burned and charred flesh, rubber, silk, or any other unabsorbable material, within the abdomen. The parts are left unbruised and without any poisonous germs in contact.

Our surgeons have met with phenomenal success in removing Ovarian Tumors, by the operation of Ovariotomy. Thus far, in a career extending over a long period of time and embracing the removal of a long list of these morbid growths, they have not had a single fatal case.

The following cases illustrate our method of treatment in a few of the many cases that have been under our care. Each case is typical of a class:



CASE I A married woman, aged 38. Had never given birth to a child. About four years before coming under our observation, she discovered a small bunch, as she expressed it, in the left ovarian region, which gradually increased in size until, when she consulted us, it caused considerable pain in the region of the liver from pressure, and interfered with respiration. Her general health was becoming much impaired. She stated that she had consulted a prominent gynecologist in this city, who had told her that the attachments of the tumor were so extensive that ovariotomy (removal with the knife) was out of the question, and that, therefore, he could only give her palliative treatment. This unfavorable prognosis only added mental anguish and despair to her physical suffering. On examination, we found a large multilocular cystic tumor, represented by Fig. 17, with very thick walls, extending from the left ovarian region obliquely upwards and to the right, so that it pressed more upon the short ribs on the right side than it did upon the left, but which filled the entire cavity of the abdomen. The attachments, as the doctor whom she had previously consulted had stated, were so extensive that its removal with the knife could not be thought of. We were not disposed, however, to give the case up as hopeless. We told her that we would do what we could for her, but as to what the result of our treatment would be, we could not definitely say. She placed her case in our hands, and we resorted to the above described treatment. She was treated two and three times per week for more than two months, at the end of which time, the tumor had decreased in size fully two-thirds. It has ever since remained stationary, and has given her no trouble or inconvenience whatever. It is now seven years since we treated her.



CASE II. A young lady of 23; unmarried. About six months previous to consulting us, she had discovered a tumor of about the size of an egg, In the region of the left ovary, which had been gradually increasing in size. On examination, we found the morbid growth to be about the size of a quart bowl, and evidently composed of several cysts with thick walls. She experienced no pain, and but slight inconvenience from its presence, but she was in great mental distress. She was an only daughter, and her mother had died a few years previously from the shock and hemorrhage resulting from an operation for the removal of a large ovarian tumor, performed by the late lamented Dr. Peaslee, of New York. The same course was pursued in this case, and at the end of six weeks' treatment, the tumor was reduced to the size of an egg, and has remained so ever since, now more than three years.

CASE III. A woman,37 years of age; married six years; no children. She had suffered for eight years from profuse menstruation and dysmenorrhea, with a membranous discharge, and, for several months before consulting us, she had experienced severe pain and a soreness in the pelvic organs. Her bowels were obstinately constipated, it being next to impossible for her to have an evacuation, and she possessed a pale and careworn countenance. Upon examination, we discovered a hard, incompressible tumor, represented in Fig. 18, attached to the posterior wall of the uterus, which caused anteversion of the womb, and which pressed upon the rectum so as to produce great obstruction. She was treated by means of electrolysis, with injections into the substance of the growth, for one month, at the end of which she resumed home, with the tumor reduced from the size of a pint bowl to the size of an egg, and her health greatly improved. After going home the tumor continued to grow less until, at the end of a few months, her home physicians could detect no trace of it, and she has remained well since, for more than five years.



CASE IV. A lady aged 36: married 13 years; no children. She complained of severe pain in the back and a frequent desire to urinate. Menstruation was profuse, and the bowels were constipated. On examination, we found an inter-mural fibroid tumor, represented in Figs. 19, developed in the anterior wall of the uterus, and pressing upon the bladder. The womb was enlarged, measuring three inches in depth, and was slightly anteflected. A month's treatment, with electrolysis and injections into the tumor, arrested the growth and diminished the size more than one-half, and caused the unpleasant symptoms to disappear.



CASE V. A married lady, 26 years of age; had borne no children, but had had several abortions, brought about intentionally. Six months before consulting us, a tumor, about the size of an egg, was discovered by her home physician. It grew steadily from the time of its discovery until, when we made an examination, it was found to be about the size of an ordinary tea-cup. It was developed in the posterior wall of the womb, as represented in Fig. 20. Three weeks' treatment reduced the tumor two thirds.



CASE VI. A widow lady, aged 52. She was examined ten years ago by two of the most distinguished physicians of New Haven, Conn., who pronounced her sufferings due to cancer of the uterus. She was then suffering from repeated hemorrhages, and other symptoms. They gave her palliative treatment, and told her that to interfere with the morbid growth would only shorten her life, and that by leaving it alone she might live several years. By and by the hemorrhages ceased and she passed the change of life, but she continued to be troubled with a sensation of fullness in the pelvis, pains in the back, and frequent headaches. On examination we found not a cancer, but a large polypus, as represented in Fig. 21, which had caused all the trouble. It was quickly removed, without pain, and her health restored. Thus, through an error of diagnosis, she was made to suffer physically and mentally for ten, long years of her life, in constant dread of a horrible death.

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TESTIMONIALS.

While we have a great cloud of witnesses testifying to the efficacy of our treatment of the diseases described in this volume, yet for lack of space we can here introduce only the following:

LARGE FIBRO-CYSTIC TUMOR.



PRONOUNCED INCURABLE BY MANY EMINENT SURGEONS. HEALTH RESTORED AND TUMOR REMOVED WITHOUT CUTTING.

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

Gentlemen—I cheerfully send you the following testimonial, and hope it may induce some sick person to seek relief where it is sure to be found.

We never truly appreciate health until it forsakes us.

For six years, I suffered all the tortures and fears attendant on the growth and development of a fibro-cystic tumor. I tried to have the tumor removed, but found it impossible. I had the very best medical advice the South affords, but every physician rendered the same verdict, 'incurable.' How that word, for months, rang in my ears—'INCURABLE.' It seemed stamped on my mind in letters of fire. What I suffered, both in mind and body, cannot be imagined. But for my unbounded faith in God's goodness and mercy, I doubt not, I would have given up and died. But I trusted in Him to direct me in the way to find relief. One hope stood out before me like a beacon light; and that was to find the means to go to Buffalo, N.Y., to Dr. Pierce's famous Invalids' Hotel and Surgical Institute. At last the opportunity came, and I bid my loved ones a sad farewell, (not one of them ever expected to see me again, alive) and with a sister to relieve me of every care on the journey, we started for the Institute.

On arriving at the Invalids' Hotel, I was too sick and fatigued to treat with civility the sweet-faced, lady-like housekeeper who received me, or the gentle nurses who tried so patiently and kindly to minister to my wants.

I had read a good deal about the Invalids' Hotel, and expected to see wonderful things; but like Sheba's Queen, I could truthfully say, 'the half had never been told.' The many ways, means, and appliances, for the relief of poor sufferers surpassed a thousand fold anything I had ever imagined could come within the scope of human skill. The skilled physicians were not only able and attentive, but on meeting one, if it were every day, they always had a ready smile, a warm hand clasp, and an encouraging word, which alone, would make one feel better and at home. The trained nurses were attentive and kind.

Every department was cleanliness itself, and kept at such an even temperature, even to the halls, that during my four months' stay, I never had the slightest cold. Not only the comforts of life, but every luxury that the most exacting could demand, were fully supplied. I saw many poor sufferers, from various diseases, made well and happy, and I too, with the other happy ones, found relief, and that without the use of the knife or an anaesthetic of any kind. I would urge all poor chronic sufferers, it matters not what the trouble may be, to go to Dr. Pierce's Institute and be cured. If any one similarly afflicted cares to know more of my case, I will gladly answer any questions, if she will only write me, and enclose addressed and stamped envelope in which to reply. During my stay at the Invalids' Hotel I never lacked for anything that willing hands and warm hearts could supply, and I came away feeling that I was leaving a sweet, luxurious home and many warm friends, but with a new lease of life and perfect confidence in the ability of the physicians, for I know I could not possibly have lived two months longer, had I not found relief. To-day I am well, rosy and happy, with a heart full of lasting gratitude for the kind treatment and cure which I received at the Invalids' Hotel and Surgical Institute.

Yours truly. Miss DELAINE DUKE, Clanton, Chilton Co., Ala.

POLYPOID TUMOR OF UTERUS WEIGHING OVER FIVE POUNDS.

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



Gentlemen—After many trials my doctors here had given up all efforts to cure me. A tumor that had existed almost from my childhood was gradually killing me. From frequent hemorrhages, I had become as pale and bloodless as a ghost, and so weak as to be scarcely able to stand or walk. Frequently the loss of blood was so great as to cause such long fainting spells that my family thought me past mortal help. How I lived to get to your place is yet a matter of wonder.

We appreciated the fact that in the skill of your surgeon lay my last and only hope. The result proved his abilities. The restoration of my health, when it was so generally and for so long despaired of, was miraculous, and I cannot sufficiently express my gratitude and thanks.

The comfort that was given by the kindly attention of your nurses is one of the very agreeable memories of your home-like and pleasant Institution. With much gratitude, I am,

Respectfully yours, Miss ANNIE BOLIN, Leon, Kan.

NOTE—The above case had been pronounced cancer of the womb by home physicians.

FIBROID TUMOR. CURED WITHOUT CUTTING.

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



Gentlemen—I cheerfully give a testimonial of my treatment at your Institution, hoping it may induce others to avail themselves of your skill. In December, 1890, I went to you, after suffering five years with two fibroid tumors of the uterus. The tumors had grown rapidly for six months prior to my going to you for treatment, and had become quite painful. Under your treatment they entirely disappeared and my health was entirely restored. The treatment I received from your able corps of physicians and nurses was all that could be desired, and I would further state that your Hotel and Surgical Institute possess all the requirements for making invalids comfortable and happy.

Yours truly, VANIA E. DRENNEN, Nelson, Portage Co., O.

OVARIAN TUMOR OF 62 POUNDS WEIGHT REMOVED.

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



Gentlemen—I hereby certify that I had safely removed, without realizing any pain, a large cyst, or Multilocular Tumor (ovarian) weighing 62 pounds, by your surgeons. Then, with kind and watchful treatment, the care of good and faithful nurses, and by the blessing of an all-wise Providence, I was sitting up in twelve days from that time; had no inflammation or fever, kept gaining, and in five weeks returned home. I am feeling better than I have for two or three years. I cheerfully and truthfully recommend the Invalids' Hotel and Surgical Institute to all afflicted as I was—with tumors, or any chronic disease. The rooms are large and pleasant, the best of food is served, and everything possible is done by the physicians, nurses, and attendants connected with the Institution, to render the visits of the afflicted pleasant and desirable.

Accept the grateful thanks of my husband and myself for your good care and great kindness to me during my stay at your Hotel, and I wish you all great success.

Very respectfully, MRS. ELISHA MATSON, Watte Flats, Chautauqua Co., N.Y.

UTERINE FIBROID TUMOR.

THE FOLLOWING IS FROM THE EMINENT LADY PHYSICIAN AND POPULAR LECTURER, MRS. JENNIE V.S. WILCOX, MD

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



Gentlemen—The least return one can render for an invaluable service, the saving of a life, is an acknowledgment of the same. Mine was a long-standing, stubborn, constitutional difficulty; chronic, and defying all previous treatment. Under the care of the doctors of the elegantly appointed Invalids' Hotel and Surgical Institute the disease yielded. Could I persuade some of my fashionable friends to spend a summer or winter at Dr. Pierce's rather than at "resorts" more or less unsuited to weary or sick people, there might rise up an improved generation. The electrical appliances at the Invalids' Hotel are probably the finest in the world. With them the administration of electricity for the absorption and removal of all abnormal growths, especially in my sex, is an assured science, and no experiment. I cordially commend all my fellow sufferers to the tender care of the Invalids' Hotel.

Yours very respectfully, JENNIE V.S. WILCOX, M.D. Saratoga Springs, N.Y.

OVARIAN ABSCESS.

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



Gentlemen—It is with pleasure that I can testify to the skillful treatment received at the hands of your surgeon specialists. I had been given up to die, with an abdominal tumor and abscess. My case was not understood, before coming to you. Although operated upon twice unsuccessfully by others, my life was despaired of. I am happy to state that after a few weeks' stay in your Institution, with a skillful operation which owing to my extreme feebleness, was performed without any Chloroform or Ether (local anaesthesia only being employed), and which resulted in the removal of the tumor and abscess, I was perfectly cured, and have since enjoyed excellent health. I am now restored to my children and family, and have much to thank you for. The kindness and attention received from your physicians and nurses while in the hotel could not be better, and I wish to praise them all highly.

Very truly yours, MRS. ANNA KEACH, 60 Bissell Ave., Buffalo.

SUFFERED FOR 20 YEARS.

OVARIAN DISEASE WITH INFLAMMATION OF ABDOMINAL ORGANS AND GREAT NERVOUS PROSTRATION.

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



Gentlemen—I most gladly express my appreciation of the treatment I received at the Invalids' Hotel and Surgical Institute at Buffalo. When I first applied to you for treatment I could sit up but a few minutes each day, and my physician had told me I never could be any better. I began to improve very soon after receiving and commencing to use your medicines. I continued to use them for some months, following the special instructions faithfully as I could, and steadily improved in health. My trouble was of such a nature that it was necessary for me to receive personal treatment, and I spent six weeks at your Institute. The kindness of physicians and attendants is everything that can be wished. It is now two years since I have had any of your medicines, and I have taken no others since, and my health is very good indeed. I can hardly realize that I am the same person that used to suffer so much for twenty years or more.

Very respectfully, MRS. M. GIBBONS, Franklin, Delaware Co., N.Y.

DISEASED OVARY.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, 683 Main St., Buffalo, N.Y.:



Gentlemen—In the Autumn of '88, I had an ovary removed at the Invalids' Hotel and Surgical Institute, Buffalo. The operation was performed with consummate skill. The Hotel is first-class in every respect, being at once a Christian Hospital and Home. The skill of man, as exercised there, seems all that God designed it to be.

I cheerfully add my testimonial as I consider the Institution first class in every respect.

Yours truly, MRS. ELLEN F. TANNER, Leavenworth, Kans.

FIBROID TUMOR OF UTERUS.

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



Gentlemen—There is no endorsement that the faculty of your Institute could ask that I would not willingly give. I fully realize that I owe not only my good health, but my life to the wonderful treatment received at the Invalids' Hotel and Surgical Institute, and would earnestly recommend any person needing the best medical or surgical attention to go for relief and cure to your Institution at Buffalo, N.Y. Words are inadequate to express the gratitude I owe you in so successfully treating my case.

Very truly yours, Mrs. C.B. SLEEPER. Brainerd, Minn.

OVARIAN TUMOR MADE UP OF SMALL CYSTS (MULTILOCULAR).



It grew to enormous size in but five months. The patient, a young unmarried woman, left home expecting to die. She had several physicians. None of them could give her any definite information as to the nature of the growth or other than unfavorable expectations as to its probable effects.

It was successfully removed. The patient being able to be up and around in about two weeks with no unfavorable symptoms. Cure perfect. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

My Dear Doctors—Many months have passed since I have written you concerning my health. I have remained perfectly well, and, in fact, my health was never better than since the tumor was removed.

You will remember my case: The tumor had only grown about five months, but it was of immense size, and I had despaired of life, and my family thought that I would not return alive from your Institution. Your skillful operation and removal of the tumor, which weighed over thirty pounds, with the kind nursing and good attention given me afterwards, brought me through sound and well. To you I feel that I owe all thanks. My prayer is for the success of the World's Dispensary Medical Association. You saved my life after I had given up all hope. The kind care that all gave me was something that could not be paid for with money. It was like being at home. I send you my picture, which will give you some idea of the change for the better in my looks. I am now married and am very happy.

Very respectfully, MRS. P.S. CRISSMAN. Montrose, Henry Co., Mo.

OVARIAN TUMOR.

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



Gentlemen—I am pleased to inform you that I have had no trouble since the removal of the tumor five years ago—that my general health is perfectly restored, and I grow stronger and stronger. And since that time I have two boys, healthy, and growing as strong as can be, and I feel very well satisfied with the care of the good and faithful nurses and physicians.

I cheerfully and truthfully recommend the Invalids' Hotel and Surgical Institute to all afflicted as I was with tumors, or any chronic disease. I send you my picture which will give you some idea of the change for the better in my looks.

Accept the grateful thanks of my husband and myself for your good care and great kindness to me during my stay at your hotel and our wishes for your best success. Respectfully,

MRS. J. NESTOR ORTIZ, Ortiz, Conejos Co., Colo.

FIBROUS TUMOR.

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



My Dear Doctors—My husband had to carry me into your place but in thirty days I walked out of the Invalids' Hotel sound and well. The tumor that caused my sufferings had gradually developed during a period of several years. The trouble induced an inflammation of the bladder and I had to endure that torment in addition. There were times when I could not touch my feet to the floor. Walking was an agony that I could hardly bear. I faithfully tried good physicians and the various remedies and treatments that were recommended to me without any satisfactory relief. So I made up my mind to go to your institution. I am now very thankful. Every one I met with in your place seemed to help me to get well.

You have got not only the most skillful physicians and nurses but they are also the kindest and most agreeable that I have ever met. Your hotel is comfortable, home-like and perfectly clean.

The treatment was wonderfully successful in my case. The removal of the tumor was accomplished without pain. I can highly endorse local anesthesia instead of using chloroform or ether. My recovery was rapid and I continue in good health and think of you all with thanks and good wishes.

Very truly yours, MRS. ADELAIDE DEAN, 246 Garden Street, Lockport, N.Y.

FIBROID TUMOR OF THE UTERUS

INVOLVING BOTH BODY AND NECK OF THE WOMB.



The tumor was of many years' standing; had grown within a few months till it was about the size of a child's head.

From anxiety and worry, the patient had grown nervous and generally miserable. It was successfully removed by electrolysis, no knife nor other cutting instrument being employed. In ten days the patient was able to be about and to return home.

Yanceyville, N.G.

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

Gentlemen—I have thought of you and prayed for your welfare ever since I left your Institution. I am perfectly well and enjoying as good health as ever I did. The treatment you so skillfully applied has completely restored my health, and I feel that I owe you a debt of gratitude that I can never repay. I am constantly sounding your praise among my friends, and know that I can never speak of you in too high terms. I once despaired of ever feeling well,—to-day, I am jolly and like another being. May you long be spared to minster to the afflicted.

Very respectfully, MRS. HANNAH JOHNSON.

NERVOUS PROSTRATION; DEBILITY; DYSPEPSIA; "FEMALE WEAKNESSES," CURED BY SPECIAL HOME-TREATMENT.

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



Gentlemen—For a number of years I suffered with a complication of female troubles; I tried various remedies from physicians but nothing seemed to do me any permanent good.

About three years ago, I suffered an attack of nervous prostration, being the result of repeated miscarriages; this was a severe shock to my nervous system, resulting in a complication of other troubles among which was nervous dyspepsia. Words fail to express what I endured at this time. Only those who have passed through a similar experience can imagine the distressing symptoms accompanying this disease; I could neither eat nor sleep, was growing very thin in flesh and life seemed a burden to me.

This was my condition when I wrote to your Institution for help. I received a very encouraging letter and commenced treatment at once. I had not used their remedies a week before I began to feel better, and as I continued the treatment my health gradually improved. All the distressing symptoms have disappeared and my general health is restored. Accept my sincere thanks for the interest manifested in my case and the happy results obtained. I am now the mother of a fine baby girl, and I shall ever remember to whom I owe my present health and good fortune.

Yours truly, MRS. J.D. NICHOLSON, La Hoyt, Henry Co., Iowa.

BED FAST FROM WOMB DISEASE AND URINARY TROUBLES.

DR. R.V. PIERCE, Buffalo, N.Y.:



Dear Sir—When I began your treatment, I was unable to be up any at all, being troubled with womb and urinary diseases; but I can gladly say that had it not been for your medicine I could not have lived a great while longer.

I hereby give your medicine a high recommendation for the marvelous work it has wrought.

Yours respectfully, MRS. PHEBE MCCLAIN, Earnest, Jefferson Co., Ala.

UTERINE AND RECTAL DISEASE.

HOME PHYSICIANS FAILED.

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



To whom it may concern—I was greatly afflicted with Uterine and Rectal disease. My disease was of very long standing and had baffled the skill of our home physicians. I went to the Invalids' Hotel and Surgical Institute, and received treatment of their specialist. Under his skillful care and kind attention I soon regained my strength and felt that my former life and ambition were again restored to me. I cannot speak in too high praise of this famous Institution; the rooms are large and cheerful, the food of the very best, the nurses kind and attentive, and the staff of physicians and surgeons skillful and of large experience.

Yours respectfully, MRS. CHAS. CLAWSON, Middlesex, Yates Co., N.Y.

FALLING OF THE WOMB, LEUCORRHEA.

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



Gentlemen—I was sick two years with "Falling of the Womb" and leucorrhoea or whites, previous to taking your medicines. I took six bottles of your "Favorite Prescription," and was entirely cured of both in six months; it is four years this month, since I was entirely well of both those diseases and have never had any signs of their appearance since, and I am satisfied the "Favorite Prescription" saved my life, for I could hardly walk around, when I commenced taking your medicine, and I think it is a God's blessing to me, and a great credit to you that I ever took your medicine, for had I not taken it, I think I would have been in the grave now, and I can highly recommend it to all who suffer from these two complaints.

I was pronounced incurable by the best doctors here in the West. I gave up all hopes and made up my mind that I was to be taken away from my husband and baby of two years old. I was sick all of the time—could not eat anything at all. In one week, after beginning the use of your medicine, my stomach was so much better that I could eat anything; I could see that I was gaining all over, and my husband then went and got me six bottles: I took three of them and my stomach did not bother me any more.

We sent to you and got the People's Common Sense Medical Adviser, and found my case described just as I was; we did what the book told us, in every way; in one month's time I could see I was much better than I had been; we still kept on just as the book told us, and in three months I stopped taking medicine, only three times a day, and continued for some time in that way, and to-day, I can proudly say I am a well woman. Yes, am well, strong and healthy. I am so glad and thankful to you, Doctor, for my good health, for well do I know you are the one that cured me.

When I began to take your medicine my face was poor and eyes looked dead. I could not enjoy myself any where, I was tired and sick all the time. I could hardly do my housework, but now I do that and tend a big garden, help my husband and take in sewing.

Yours respectfully, MRS. MARY F. COVELL, Scotland, Bon Homme Co., So. Dak.

SEVERE NERVOUS PROSTRATION.

"OUT OF DARKNESS INTO LIGHT."

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



Gentlemen—About eighteen years ago, after the birth of one of my children I was left in a weak, run-down condition; it seemed to me that my nerves were unstrung very bad: I did not suffer much pain, but I think I suffered everything any one could suffer with nervousness; my life was a misery to me. I doctored with seven different doctors and got no relief; then I took almost all kinds of patent medicines and got no relief from them, but got worse all the time, when I chanced to get one of your little pamphlets.

I thought I would write to you, and waited as I thought to hear that there was no help for me; when my answer came and you said you could cure me great was my joy. I had taken your medicine about a month when I began to improve and in a few months was entirely cured.

My recovery was like coming out of the dark into the light, so great was the change. I will advise all sufferers to go to you for relief—I don't think they will be disappointed. When I commenced taking your medicine I weighed 94 pounds, now I weigh 125 pounds.

I do not know how to thank you for all the good your remedies did me, With heart-felt thanks I am,

Sincerely yours, MRS. AMANDA C. AUSTIN, Burden, Cowley Co., Kansas.

P.S.—I have a lady friend who is taking Dr. Pierce's Favorite Prescription now, and last summer every one thought she was going with consumption; four of her father's family had died with it in five years: she has taken one bottle of "Favorite Prescription," and now she is better in health than she has been in three years. Her address is Mrs. Laura Paugh, Burden, Cowley Co., Kas. A.C.A.

MONTHS OF SUFFERING AND TORTURE.

"LEFT TO DIE A HOPELESS WRECK."

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



Gentlemen—A grateful heart and an appreciation of your medical skill prompts me to make a statement of my case.

At the birth of my last baby (a boy weighing 14 pounds at his birth), I contracted womb disease. And for three years previous to treatment, I had been a great sufferer from prolapsus. Owing to a more serious injury than prolapsus, received at childbirth, my physicians told me that "I could never hope for recovery."

After delivery, I kept my bed for seven weeks. At the expiration of that time I tried to walk. I found that I could not even stand straight; there seemed to be a "tight cord" or "drawing" from my left side extending down into my groin, accompanied by great soreness.

After repeated attempts, with my body inclined to that side and yielding to the drawing, I finally succeeded in walking—a violent trembling all the while in the parts affected.

Three months after the birth of my baby, I tried to take hold of my household duties—then my troubles increased, and with them came a series of "Doctors' bills."

I consulted two of the best physicians, besides trying all the medicines I heard tell of, that were recommended for such diseases; but failed in obtaining a cure from any of them; my relief was only temporary. My condition was growing worse each day; the womb was so low and the "bearing down" weight so great that I could scarcely stand on my feet at all. I was irritable and nervous with a dull headache and constipation; hands and feet cold and clammy, except the palms and soles; a burning on top of my head. At this stage of my disease my bladder was badly affected—the "neck" becoming enlarged and the water collecting there caused a protrusion to over half the size of a tea cup, leaving it so dry and harsh, that it was with the greatest difficulty I could walk at all; a sudden jar, sneeze, or even the slightest pressure, would force the water out, leaving me in a spasm of pain. At this stage (22 months after confinement) menstruation returned for the first time since the birth of my baby. I had already suffered as much as I thought it possible to bear, and live, but my sufferings were even greater after this; my womb was ulcerated and inflamed; nervousness increased to violent shaking, over which I had no control; circulation so feeble that the extremities were scarcely supplied with blood, they were constantly cold and clammy. My sleep broken and disturbed, life was fast becoming a burden to me, For months, however, I endured this torture; I had abandoned work altogether; I could be up but a few moments at a time and could not walk across the floor without excruciating pain. There was no sleep, no rest, and after a week and even more, would pass during which I would never close my eyes in sleep, even when morphine, opium and chloral, were administered. My body seemed a dead weight, while my mind was alive to all my sufferings. There seemed to be a burning pressure about my head all the while.

I would have shaking spells frequently, leaving me perfectly exhausted, my heart the while beating so rapidly, I could not count the pulsations; it seemed to cease altogether after that, with a sinking, fainting feeling over me, making it difficult to breathe at all. During my menstrual periods I suffered a "thousand deaths." My appetite was gone, mind and sight impaired, strength and flesh all gone. I was a pitiable object to look at, divested of all that made life endurable for me. I had baffled the skill of two physicians, and was left, after three years of agony, to die, a "hopeless wreck," worse than death.

Such was my condition when I applied to you for treatment. After using medicines only six days I began to improve; my nerves were steadier; circulation better, hands and feet warm. Nine days after taking your medicines they restored the function again. I will confess I expected to suffer death again—I did not think the medicines had had time to effect a change within so short a time. Imagine my joy and surprise upon waking next morning to find it had "stolen like a thief upon me in the night," I knew not when. I spent the day in grateful tears—how could I help it? It passed off as quietly as it came, leaving my head clear of that dreadful, burning pressure! My nerves were steady; indeed, my improvement was so remarkable, that it seemed almost a delusion. My appetite had returned, and I was hungry for the first time in over a year. I slept well—awoke refreshed and feeling stronger. After two weeks, I was able to walk around the house and yard without support; a day or two after that I walked a hundred yards, visiting and spent the day. In three weeks time I went home (I had gone to my mother's before treatment, as I and many others thought, to die).

At the end of one month there was no symptom, nor sign, of the old disease. I was able to be up all day, resting a short time at noon. To be sure of permanent results I continued treatment for one month longer, and have never had a return of the disease nor any symptom of it since. Before the end of the second month, I was able to be about the house, helping the children with the cooking, and milking. My weight increased fourteen pounds in five months after treatment. I have taken no medicine since except one bottle of Dr. Pierce's Favorite Prescription, four years ago. At this time (nine years after treatment), I find my health still good, having no aches nor pains, a splendid appetite, sleep well, no headache, no backache and no womb trouble. I am able to do my house work and everything; can do a day's work with less fatigue than I have for years before treatment. I feel sure that I would have been in the grave years ago if it had not been for your medicines. I advise all other ladies who are troubled with the same disease to apply to you for treatment.

Be assured, that whenever I have it in my power I shall recommend your invaluable remedies. I thank you a thousand times for what you have done for me, and for the kindness which you have extended to me throughout.

Wishing you long life and continued success, I am, with much gratitude,

Very truly yours, Mrs. JENNIE S. MOODY, Isney, Choctaw Co., Ala.

COMPLICATED CASE OF WOMB DISEASE.

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



Gentlemen—When I went to the Invalids' Hotel for treatment I was in a very critical condition. I could scarcely walk for inward troubles—but I cannot stop to speak of one disease, for I had such a complication of diseases. Now I am doing my own housework and in the past four weeks I have entertained forty-seven people, and I think I certainly am doing well. It is with the greatest pleasure that I recommend all who are afflicted to go to the Invalids' Hotel and Surgical Institute. The Surgeons are honorable, trustworthy gentlemen, who will do all they promise; and, being men of large experience, they know just what course of treatment to pursue from first to last, so that an invalid can rest assured that no experimenting will be done.

For seventeen years I was an invalid and never had better health than at the present day, for which I am grateful to your Institute.

Yours respectfully, Mrs. D.T. KNAPPENBERGER, Jeannette, Westmoreland Co., Pa.

UTERINE DISEASE.



Gentlemen—For eight years I was a sufferer from female derangements. I have been permanently cured by your specialist, and with only thirty days' treatment. I am happy to say there is no return of the old trouble, and all my friends were so surprised to see me so well after being an invalid so long. I shall never regret the day I went to the Invalids' Hotel. You ought to see me now—I am so healthy, I shall never forget your kind treatment of me, and the nurses too were so kind and attentive—I cannot say too much in their praise.

Respectfully, MRS. J.W. REEL, Idaho City, Boise Co., Idaho.

PAINFUL MENSTRUATION AND CONSTIPATION.

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



Gentlemen—In April, 1891 I came to your Invalids' Hotel for examination and treatment. I was at that time suffering from profuse and painful menstruation, complicated with obstinate constipation, from which I had suffered many years. I cannot speak too highly of your treatment of my case, as it was both prompt and thorough and resulted in a radical cure of the above named diseases, and I desire to recommend all who are thus afflicted to apply to your eminent staff of physicians for relief, as they cure when others fail. My advice to all who are afflicted is, if you wish to get well, go where they make such diseases a specialty. I hope that many others may be as thoroughly cured as I have been.

Yours truly, Miss ELLA DORAN, Tiffin, Seneca Co., O.

COMPLICATION OF DISEASES CURED BY SPECIAL HOME-TREATMENT.

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



Gentlemen—I suffered from female complaint; my kidneys, stomach and nerves were also affected. My physician told me I had Bright's Disease of the Kidneys. I suffered a great deal in various ways, at times. I felt as if life were a burden to me; about that time Dr. Pierce's Common Sense Medical Adviser came into my possession. I read it carefully, and I thought if Dr. Pierce can not cure me perhaps he can give me some relief. I wrote to him, describing my symptoms and feelings as well as I could, and asked him if he could cure me. He said he thought he could, but it would take a long time for my disease was deep seated. He sent me a box of medicines enough to last one month, especially prepared for my case.

I continued taking his medicines for about thirteen months, and at the end of that time I felt like a new woman; that has been almost seven years now and my health is still good.

The benefits derived from Dr. Pierce's Medicines are lasting, and I advise all women suffering as I did, to give his medicines a fair trial.

Gratefully yours, MRS. MARY SHEEN, Council Bluffs, Iowa.

PARALYSIS AND UTERINE DISEASE.

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



Gentlemen—I will say that your Institute is all that you claim for it, and more to. The Doctors are courteous gentlemen and the best Physicians I have ever met with in my life. My treatment while at the Institute did me more good in one month than all the doctors everywhere else combined. My ailment was Paralysis and Female Weakness. Your treatment did me good while at the Institute, and I have also been greatly benefited by the home-treatment I have received from you since. I am much better than I was; I am able to do considerable work now. When I came to you I could not do anything.

I herewith send you my heartfelt thanks for all you have done for me, and should I need more treatment I will write you as before. I would advise all people who have chronic diseases to go to the Invalids' Hotel and Surgical Institute for help, for it is a grand place and prices are reasonable. We use your Family Medicines—your "Pellets" and "Golden Medical Discovery"—and find they are all you claim for them.