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This subject will receive a more full and complete consideration in another part of this treatise.
THE PROSTATE GLAND.
The prostate is a gland of about the size and shape of a large chestnut, lying just in front of the bladder, and surrounding the urethra. The size of the prostate gland varies considerably with the age of the person. In early life it weighs but a few grains. As puberty approaches it becomes larger, and in the adult weighs from half an ounce to an ounce. In old age it enlarges considerably, and sometimes presses upon the bladder so as to impede the flow of urine. This condition is often confounded with stricture, gravel, or stone in the bladder, by inexperienced physicians. Hypertrophy, or enlargement of the prostate gland, is not an unfrequent disease in the adult or middle-aged man. Being in close contact with the bladder, when it enlarges it encroaches on the bladder, pressing on it, and it has the effect of interfering with the function of urination. As before indicated, enlargement or hypertrophy of the prostate gland, is often confounded with stricture, gravel, and stone in the bladder, by inexperienced physicians, and treated accordingly. The true condition of this gland is readily determined by an examination through the rectum or lower bowel, the finger of the expert surgeon being able to determine at once whether it is enlarged or not.
THE DANGER OF BAD TREATMENT. In disease of the prostate gland, as well as in inflammation of the kidneys and bladder, stricture of the urethra, and many other forms of urinary disease, the use of stimulating diuretics, and the much-advertised "kidney cures," "buchus," and similar preparations, which largely increase the flow of urine, simply aggravate, and do positive harm. In fact, the most difficult cases that we have had to deal with have been those that, through such treatment, either taken on their own account or prescribed by inexperienced physicians, have been rendered so much worse as to make their cases very intractable, and tedious to relieve and cure.
REQUIRE NICELY ADAPTED TREATMENT. As we have heretofore indicated, there is no class of diseases that require nicer adaptation of medicines to each individual case, than those of the urinary organs. Medicines which, in one stage of these diseases are beneficial and curative, in another stage are often exceedingly injurious. Hence it is that we claim it to be impossible for any one to put up any set prescription, or proprietary medicine, that will meet the wants of a large percentage of this class of cases. The only rational course to be pursued is to examine carefully each case as it is presented; find out the exact condition and stage of the disease with which the patient is afflicted, and then prescribe for it such special medicines as are nicely and exactly adapted to the patient's condition. These, in many cases, will have to be changed from time to time, to suit the ever-changing condition of the disease, as it is modified by the treatment. Not only have the manufacturers of "buchus," "kidney cures," etc., committed grave errors by prescribing stimulating diuretics for almost all kidney and bladder diseases, under the impression that, as the patient passes only a small quantity of urine at a time, the kidneys should be stimulated to secrete more, but physicians in general practice have been very prone to commit the same error in their practices. When the bladder and kidneys are in a weak and diseased condition, incapable of efficient action, the bladder being already unable to dispose of the diminished quantity of urine secreted, it is simply outrageous practice to administer medicines calculated to stimulate the kidneys to perform more work. By being thus forced, these organs become seriously diseased. It would appear most unreasonable to whip and spur a horse already jaded from overwork. Common sense would dictate rest, which always does good; but, as the bladder is weak, the doctor whips up the kidneys with drugs, thus endeavoring to force them to secrete more urine, and thereby the poor, crippled bladder, which is incapable of disposing of even the diminished quantity secreted, is actually made to do more work in a diseased and feeble condition, than it would perform in a sound, strong, and healthy state. The results of this pernicious practice are Bright's disease of the kidneys, cystitis or inflammation of the bladder, and numerous other grave maladies.
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KIDNEY DISEASE.
Diseases of the kidneys are generally very slow in their inception, coming on gradually and manifesting no special symptoms of their presence until they have assumed a formidable character. For this reason they are the more dangerous. Simple derangement of the urinary secretion is no evidence of disease of these organs, as changes in the color, quantity and specific gravity of the urine are often produced by changes of temperature, active or sedentary habits, mental emotion, and sometimes by articles of diet, or drink, as well as by the use of different drugs.
The existence of disease of the kidneys in the early stages can only be positively determined by a microscopical and chemical examination of the urine, which reveals to us the presence of casts, epithelia, blood, pus, etc. The microscope informs us not only of the presence of disease, but very often of the particular portion of the kidney in which it is located, as well as of the stage which the disease has reached. We are also aided by chemistry in determining the exact abnormal condition of the kidneys by the detection of albumen, sugar, etc. These examinations, by aid of the microscope and chemical re-agents, should never be neglected by the physician. Without them his diagnosis, or judgment of the patient's condition, is simply guess-work. With them he is enabled to base his treatment upon certain and positive knowledge of the patient's real and true condition.
The usual symptoms of chronic disease of the kidneys, but which vary materially with the age, constitutional peculiarities and temperament, are weakness in the small of the back, pains in the region of the loins and groins, numbness of the thigh on the side of the affected kidney (for often only one organ is affected), high-colored and often scalding urine, many times depositing a sediment, sometimes white or milky urine, bloody urine, frequent desire to pass the urine, partial impotency, pains in the testicles and shooting into the loins, suppression or inability to pass the urine, gravel, stone in the bladder, dropsical swellings, swelling of the testicles, irritability and pain in the bladder, mucous and sometimes seminal discharges oozing from the urethra.
WHEN THE BLADDER IS AFFECTED the prominent symptoms usually complained of are irritability of the bladder, accompanied by a frequent desire to urinate, inability to retain more than a small quantity of urine, and this for a short time only, pain in the region of the bladder, extending into the back, thighs, etc., hot scalding sensations in passing the urine, sediment in the urine, and sometimes bloody urine. The appetite is usually diminished, there is a depression of spirits, the urine is often passed only by drops, and is irregular in quantity and quality, frequent inability to pass the urine at all, in males partial impotency, with dull disagreeable pain in the testicles and irritation of the urethra, attended with mucous and sometimes seminal discharges oozing from the urethra. Some of these symptoms may be present as the result of functional or organic disease of other organs than the kidneys or bladder, and to distinguish them with positive certainty is impossible without the aid of a microscopical and chemical examination of the urine.
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BRIGHT'S DISEASE.
This affection may appear in either an acute or chronic form. The acute form is frequently a complication, or sequel of scarlet fever, diphtheria, cholera, typhoid fever, erysipelas or measles, and is frequently developed by intemperance. The acute form of the disease is very rapid in its progress, often destroying life by uraemic poisoning—the retention of urea in the system.
The symptoms of the acute form are diminution or suppression of urine, dry skin, chills, thirst, pains in the loins, and a general dropsical, puffy condition of the system, especially manifesting itself in the earlier stages under the eyes, but gradually showing itself in the oedema, or swelling of the feet, and lower extremities generally. Unless promptly relieved, the patient dies of coma (stupor), or from convulsions. No person should be so rash as to attempt the treatment of this dangerous affection without the aid of the best medical skill that can be procured.
IT IS THE CHRONIC FORM OF BRIGHT'S DISEASE that we propose principally to discuss in this article. True Bright's disease of the kidneys is an insidious and most fatal form of organic disease.
We venture to assert that less than one per cent. of those who imagine they have "Bright's," have this disease at all. We find that most of those who, as one of our Faculty puts it, insist upon having Bright's disease, base their "diagnosis" upon the ever-changing condition of the urinary secretion, and especially upon the copiousness of the deposit; whereas, in true Bright's, deposits of any kind are rarely met with. Perhaps the form of deposit most commonly mistaken for Bright's disease, is that known to medical men as the urates. When the urates are in excess they form a heavy pinkish deposit of a flocculent nature within from five to thirty minutes after the urine has been passed—that is, after it has been passed sufficiently long to cool. To prove that the deposit is urates, heat the specimen to the temperature of the blood, when the deposit in question will disappear. Excess of urates has now been definitely traced, in the majority of instances, to functional torpidity of the liver.
Another common form of deposit is that in which the reaction of the urine, instead of being acid, as in health, is either neutral or alkaline, and in which the earthy phosphates are precipitated for this reason. The earthy phosphates, when thrown down by a neutral or an alkaline condition of the urine, appear as a heavy white deposit, which, though usually devoid of clinical significance, is certainly calculated to frighten timid patients who read of the "terrible ravages of Bright's" in the advertisements of various popular "kidney cures." To prove that the precipitate is phosphatic in its nature, add a few drops of vinegar and it will disappear; whilst, if, after the vinegar has been added, the specimen be brought to the boiling point, not only both the urates and phosphates remain in solution, but there is only one single substance known to pathological chemistry that can form a deposit under these conditions—and that substance is albumen, which, if present in quantity, is always indicative of serious disease.
The papers are filled with the plausible but unwarranted statements of the manufacturers of various "kidney cures," who anxiously desire that every one should be impressed with the idea that all their troubles arise from kidney disease in order to sell large quantities of their medicines. In many cases the unfortunate patient is rendered much worse by the use of remedies that are not suited to his condition, and which will not cure the real trouble with which he is affected.
Daily we are consulted by persons in whose cases these errors have been made. In reality, true Bright's disease is not a common affection, and nine out often individuals who think that they suffer from it, or the early stages of the trouble, in fact have something more curable. In some cases it is an affection of the liver, which forces an excretion of unnatural salts by the kidneys, and thus renders the urine acrid and irritating, or they may be suffering from some other disease, such as a deformity or enlargement of certain glands, as the prostate; unnatural position of the organs, as with women who suffer from weakness, the uterus pressing forward on the bladder and urethra, and thus showing every evidence of disease in the urinary canal. It is as common for persons to suffer from deformity of the urinary canal as from misshapen limbs, or from noses and ears not of proper size and proportion.
The urinary canal, from the bladder outward, is narrow and delicate. Any disease or injury therein is liable to result in gradual contraction, which may be manifested long years after the cause has been forgotten, or has disappeared. These affections, to the inexperienced, or the physician who is not particularly alert and cautious in his diagnosis, are liable to cause error, and he will pronounce a given case Bright's disease, when in reality there is some simple cause for the irritation of the urinary canal, and the pains in the kidneys, etc., all of which frequently result from a slight damming up of the flow of water, and the prevention of free expulsion from the system of the salts of which the body is relieved by the kidneys. They cannot work under pressure. When, from any cause, the flow of water is checked, and, as it were, dammed up so that a slight pressure is put upon the kidneys below, their secretion is most materially interfered with, and the many trains of symptoms that usher in disease of the kidneys, appear.
The true, and only sure way to relieve these conditions, as can be understood by any one, is to remove the real cause. The use of any medicine that stimulates the kidneys to an irritable action, under such pressure, is to be avoided, as it only makes the trouble worse, increases the amount of water that is dammed up, and results in more serious manifestations of constitutional disease; whereas, by merely relieving the choked outlet, the flow of water becomes free, and the kidneys are speedily restored to their natural condition. This is well illustrated by the following:
Case 113,396.
As recorded at the Invalids' Hotel. L.C.K., farmer, age 41, married. For a period of nearly ten years, as a result of slight injury, he had suffered from cloudy and unhealthy-looking water, with some burning on passing it; frequent calls to urinate; swelling of the limbs, loss of energy and strength; headache, etc.; gradually there appeared severe pain in the back, at times recurring with a sense of fullness in the abdomen. For a period of nearly eight years he had been constantly treated by physicians at his home, all of whom had investigated his case. He had made several long journeys to consult the manufacturers of a much-advertised "kidney cure," who, after pretending to examine his urine, scientifically (none of the proprietors are physicians), assured him that, without the shadow of a doubt, his disease was Bright's, and that he might be cured by their "kidney cure," which was for sale at all drug stores. For a period of eighteen months he steadily took this "cure," which, he states, he is sure aggravated his disease, as, although his sufferings at times were less, he felt that he was not improving in the least, and that his disorder was not being properly controlled. His home physician went with him on several occasions, consulted with the owner of the proprietary medicine, and was equally mistaken in his diagnosis. After consulting many doctors, all of whom assured him they could give him treatment that would prolong his life somewhat, and make his condition comfortable, but that no treatment would affect his cure, he was induced, by reading our article, heretofore referred to, to consult us. A very thorough examination of the case was made, which resulted in finding two contractions of the urethra, which admitted only the smallest sized probe, and which, necessarily, prevented the free flow of the urine. These were speedily removed, when, much to the surprise of his family physician, who accompanied him, over thirty-seven ounces of fluid were drawn from the bladder. This gave him immediate and perfect relief. The pains and aches in the region of the kidneys, the weakness and tenderness, and the many other uncomfortable symptoms with which he was troubled, all disappeared. From a feeble and irritable invalid, in a few weeks he was converted into a happy and cheerful man. The symptoms of congestion and irritability of the kidneys gradually disappeared, and in thirty days after visiting us he writes that he feels himself entirely sound and well. This gentleman states that he will be pleased to correspond with any one who wishes to learn the particulars of his case, and his full name and address will be furnished to any inquirer.
Bright's disease when fully established is characterized by degeneration of the kidneys. Submitted to examination, after death by this disease, these organs present various appearances. Hence, the degeneration that characterizes the disease has been designated as waxy degeneration. Some pathologists contend that the disease consists of several different renal maladies, all of which, however, agree in the one ever-present symptom of a more or less albuminous condition of the urine.
As to the causes of kidney disease, it may be said that any thing which will give rise to a greater or less degree of congestion of the kidney will induce either a temporary albuminous condition of the urine, or a true Bright's disease of the kidneys. Suppression of perspiration, by exposure to cold and wet, want of cleanliness, deficiency of nutritious diet, liver disease, certain poisons in the system, as of scarlet fever, measles, erysipelas or diphtheria, taken in conjunction with sedentary habits, bad air, excessive mental labor or worry, may each occasion an albuminous urine, and finally result in Bright's disease, but of all causes that appear to produce this disease, none are so prolific as intemperance. A scrofulous diathesis, or habit of body, may strongly predispose to the disease, and chronic kidney disease frequently follows acute rheumatism and the practice of masturbation. In some instances the chronic form of Bright's disease follows an acute attack, but is more often developed slowly and insidiously without any known cause.
THE SYMPTOMS of this fatal malady generally appear so gradually that they excite but little or no concern until it has reached its more advanced and dangerous stages. Frequently, a puffy, watery or flabby condition of the face, particularly under the eyes, is the first symptom noticed, and the patient may observe that his urine is diminished in quantity. The urine is sometimes abundant, but generally more scanty than in health, is acid in its reaction, and generally of a low specific gravity. The countenance is generally somewhat pale and bloodless, which, taken with the dropsical condition of the system, and the constant albuminous condition of the urine, points the expert specialist to Bright's disease of the kidneys. Various circumstances and conditions may give rise to the temporary presence of albumen in the urine, and, although albumen may be temporarily absent from the urine even when Bright's disease exists, yet this is not common. There are certain indirect symptoms which point clearly and almost unmistakably to the presence of this disease. These are deep-seated pain or weakness in the back, gradual loss of flesh, red, brown, or dingy urine, more or less drowsiness, and as the disease advances, a smothering sensation, or difficulty in breathing, with dropsical puffiness or swelling. Occasional attacks of nausea and vomiting are common; pains in the limbs and loins, which are often mistaken for rheumatism. Irregularity of the bowels is also common. The skin becomes harsh and dry, not perspiring even under active exercise. Sometimes these symptoms are years in their development, being very obscure at first, and in some cases the disease has been known to prove fatal without the patient having experienced any extraordinary symptoms. With those whose systems are enfeebled by want, intemperance, exposures or disease, as scrofula or syphilis, the first symptoms usually observed will be a frequent desire to urinate, occasional attacks of diarrhea, flatulency, dropsical swelling of the face, especially under the eyes, and afterwards of the extremities, paleness and increasing debility. Stupor, apoplexy and convulsions are the forerunners of a fatal termination.
Microscopical and chemical examinations of the urine are the only reliable means of diagnosis, and should be often repeated. (See Urinary Signs, in Appendix.) As albumen is often present in the urine without the existence of Bright's disease, it is impossible, except by the aid of the microscope, to distinguish true Bright's from other affections of the kidneys. In both purulent urine, and that containing blood, albumen will be found by the usual tests, but in smaller quantity than in Bright's disease. Albumen, with disintegrated epithelia, hyaline, and large granular casts, as well as waxy casts, are peculiar to, and characteristic of, this disease.
In the treatment of this malady, our specialist's experience has been very great, and attended with marvelous success. Of course, after the substance of the kidney has degenerated and broken down, and become destroyed to any great extent, a cure is impossible. But that we now possess remedies of great value, and specific power over this terrible disease, we have the most positive evidence in the remarkable success attended in its treatment. Most cases that are curable can be managed successfully at a distance, the necessary medicines being sent either by mail or express. Our specialists have cured many in this way who were so bloated from dropsical effusion as to weigh twenty-five to forty pounds more than usual. In our Sanitarium, where we have had the advantage of our Turkish baths and other appliances, we have cured some cases in which the removal of the dropsical effusion reduced the patient's weight sixty pounds.
We cannot, In conclusion, too strongly condemn the general resort to strong diuretics so often prescribed by physicians for all forms of renal maladies, but which, by over-stimulating the already weak and delicate kidneys, only aggravate and render incurable thousands of cases annually. Not less harmful are the many advertised "kidney cures," "kidney remedies," "buchus," and kindred preparations. They all contain powerful, stimulating diuretics, and, while they may appear for a short time to do good, invariably render the case worse and far more difficult to cure. The cases of Bright's disease reported cured by these preparations are cases of far less dangerous maladies, made to appear, by exaggerated accounts of them, as true Bright's disease. The use of these general, ready-made or proprietary remedies in any case of true Bright's disease is hazardous in the extreme. In no disease is there greater necessity for treatment nicely adapted to the exact condition of the patient (which should always be carefully ascertained by microscopical and chemical examinations of the urine) than in this. As it is a disease that runs a slow course, there is always time to send samples of the urine for examination by expert specialists, and no other physician than a specialist of large experience should be entrusted with the treatment of a malady so dangerous in its character, and in the diagnosis and treatment of which general practitioners commit such frequent, and often fatal, errors. (SEE TESTIMONIALS.)
DIABETES. (POLYURIA AND GLYCOSURIA.)
There are two essentially different varieties of this disease, one of which is called Diabetes Insipidus, or Polyuria, and the other Diabetes Mellitus, or Glycosuria. The first is characterized by an increase in the amount of urine excreted, and yields readily to proper treatment. The second is characterized by the presence of sugar in the urine, and under ordinary treatment often proves fatal.
The causes are obscure, and are therefore not very well understood by the profession.
SYMPTOMS. A notable increase of the quantity of urine excreted is the first symptom which attracts the patient's attention. Frequently, several quarts, or even gallons, of urine are daily excreted, and it is paler than natural. The patient experiences extraordinary thirst, and has an almost insatiable appetite, though at the same time he loses flesh and strength. The tongue may be either clammy and furred or unnaturally clean and red. The bowels become constipated, and a peculiar odor is observed in the patient's breath and exhales from his body. The skin becomes harsh, dry, and scurfy. There are dizziness, headache, dejection, lassitude, and not unfrequently blindness, caused by cataract, is developed in one or both eyes. The intellect is blunted, and, as the disease progresses, the emaciation and debility increase, and pulmonary diseases develop; or, perhaps, an uncontrollable diarrhea sets in, and the patient dies from exhaustion.
In this disease, as in Bright's, we have many medicines that produce specific curative effects, enabling our specialists to treat it with greatly increased success. The disease is readily diagnosticated, or determined, by chemical examination of the urine, so that we have been enabled to treat this class of cases very successfully at a distance, and without personal examinations. Great attention should be paid to the diet in these cases. It should be highly nutritious, but anything of a sweet or starchy nature must be avoided.
The following articles are wholesome and afford sufficient variety, viz.: of animal food—beefsteak, game, poultry, fish, eggs, cheese, cream, butter; of vegetables—spinach, dandelion greens, turnip tops, watercresses, lettuce, celery, and radishes; of drinks—tea, coffee, claret, water, brandy and water, beef-tea, mutton-broth, or water acidulated with tartaric, nitric, citric, muriatic, or phosphoric acid. The forbidden articles are oysters, crabs, lobsters, sugar, wheat, rye, corn or oatmeal cakes, rice, potatoes, carrots, bests, peas, beans, pastry, puddings, sweetened custards, apples, pears, peaches, strawberries, currants, etc., also beer, sweet wines, port, rum, gin, and cider. (SEE TESTIMONIALS.)
CHRONIC INFLAMMATION OF THE BLADDER. (CHRONIC CYSTITIS.)
This affection, also called catarrh of the bladder, is an inflammation of the mucous lining of this organ. It may occur at any period of life, but it oftenest appears in the aged, and is usually associated with some obstruction to the flow of urine.
CAUSES. It may be due to colds, injuries, irritating diuretics, injections, extension of disease from the kidneys or adjacent organs, intemperance, severe horseback riding, recession of cutaneous affections, gout, rheumatism, etc.; but it more frequently results from stricture of the urethra, enlarged prostate gland, gravel, and gonorrhea. It is also caused by an habitual retention of the urine, and sometimes results from masturbation or self-abuse.
SYMPTOMS. There is an uneasy sensation in the bladder, and heaviness and sometimes pain and weakness in the back and loins. The urine is scanty, and, although there is a desire to void it frequently, it is passed with difficulty. If allowed to stand, it deposits more or less mucus, which is sometimes mistaken for semen. As the disease progresses, the quantity of the mucus increases. It is very viscid, and adheres to the sides of the vessels, so that if an attempt be made to pour it out, it forms long, tenacious, ropy threads. Sometimes the quantity of mucus is so great that on exposure to cold the whole mass becomes semi-solid, and resembles the white of an egg. The excreted urine is alkaline, acrid, exhales a strong odor of ammonia, and soon becomes exceedingly fetid. Sometimes the urine becomes so thick that great difficulty is experienced in expelling it from the bladder. Nocturnal emissions, impotency, and loss of sexual desire are apt to ensue. Occasionally there will be a spasmodic contraction of the bladder, with straining and a sensation of scalding in the urethra, and sometimes the patient is unable to urinate.
When ulceration occurs in the progress of the disease, as it is apt to in its advanced stages, blood will occasionally be seen in the urine. In the advanced stages of the disease the system becomes greatly debilitated, emaciation supervenes, with hectic fever, nervous irritability and, finally, death.
TREATMENT. A strict observance of the rules of hygiene is essential to a cure. We must ascertain the cause if possible, remove it, and thus prevent it from perpetuating the disease. The various causes and conditions involved in different cases demand corresponding modifications of treatment; hence, it is useless for us to attempt to teach the non-professional how to treat this complex disease. We have succeeded in curing many severe cases without seeing the patient, being guided in prescribing by indications furnished by microscopical and chemical examinations of the urine. (See Urinary Signs in Appendix.) In fact, nearly all cases can be cured at their homes, and without a personal examination being made. In the worst cases, we have found it best to have our patients at our institution, where we can wash out the bladder with soothing, healing lotions, and thus make direct applications to the diseased parts. (SEE TESTIMONIALS.)
GRAVEL.
When the solid constituents of the urine are increased to such an extent that they cannot be held in solution, or when abnormal substances are secreted, they are precipitated in small crystals, which, if minute, are called gravel. Another cause of the precipitation of these salts is a stricture of the urinary canal which, by interfering with the free expulsion of all the fluid from the bladder, results in the retention of a portion, which gradually undergoes decomposition. Salts from the urine are thus precipitated in the same way that they are thrown down in urine which is allowed to stand in a vessel. Any one can illustrate this, by allowing a small quantity of the urinary secretion to stand for a few days either in an open or a closed bottle. Soon a white, flaky deposit will be observed, which will become more and more dense, and finally fine grains will be seen precipitated at the bottom of the bottle. Similar grains, lodging in the folds of the bladder, gradually increase in size, by the precipitation of more salts around them, and ultimately become a source of much irritation. When of large size, they are termed calculi or stones. When these formations occur in the kidneys they are termed renal calculi; when in the bladder, vesical calculi. There are several varieties of gravel, each depending upon different conditions of the system for its formation. The two prominent varieties are the red, containing uric acid, and the white, or phosphatic, gravel.
SYMPTOMS. When the deposits are in the kidneys, there is pain in the back and loins, occasionally cutting and severe; sometimes it darts down the course of the ureter to the bladder, and extends even to the thighs. When the deposits are in the bladder, there is a frequent desire to urinate, with a bearing-down, straining pain; also a cutting or scratching sensation in the urethra during micturition. In the male, intense pain is often experienced at the end of the penis. When the urine is voided in a vessel and allowed to settle, a gravelly deposit is seen, generally of a red or a white color, and the particles varying in size.
TREATMENT. These urinary deposits indicate a general derangement of the system, as well as a local disease. Nutrition is imperfect and some of the excretory organs are not properly performing their functions, or, perhaps, some portion of the body is being too rapidly wasted. Very frequently we find these gravelly formations as the result of a rheumatic or a gouty diathesis. It is also a well-known fact that torpidity of the liver throws an excessive amount of work on the kidneys. These organs then, in part, perform the function of the liver, and hence unnatural activity is required of them, and the secreting of such substances as uric acid, which precipitates readily and gives rise to severe irritation of the urinary canal.
In order to treat these cases rationally and successfully, it is first necessary to ascertain by microscopical and perhaps chemical examinations, the character of the deposit. By such an examination, the exact condition of the system which gives rise to these abnormal products may be definitely determined, and the remedies to be employed indicated. As the non-professional are not qualified to make such examinations, it would be useless for us to suggest specific treatment for the various forms of this affection.
Samples of the urine may be sent to us with a brief description of the symptoms experienced, and the proper medicines to cure can be returned by mail or express. Our specialists are treating, with uniform success, large numbers of cases in this way. (SEE TESTIMONIALS.)
STONE IN THE BLADDER.
Few affections to which the human flesh is heir are more painful than this terrible affliction. The cutting operation heretofore required to remove it, is considered one of the most dangerous operations that the surgeon is ever called upon to perform.
The death of the Emperor Louis Napoleon, of France, from an operation for the removal of a stone, at the hands of surgeons renowned for their skill, gave new impetus to the efforts of surgeons to invent some method that would be less dangerous than that which has been heretofore commonly employed. The cutting operations have been the rule. Of these the operation by median-section is the safest, and is most commonly employed for the removal of stones that are not too large, while the lateral operation is used where the stone is more than about one inch in its smallest diameter.
As will be seen by the consultation of any hospital record, the deaths in these various operations have been, in adults, from one in three to one in every four cases—a very large percentage, and sufficient to deter any sufferer from undergoing an operation except for the relief of a condition which is in itself worse than death. Even when this alarming death-rate is explained to sufferers, they willingly undergo the operation, feeling that they would rather die than longer continue in their pain and anguish.
Our specialists, not satisfied with the results of these operative measures, in their studies of the disease endeavored to perfect some other means by which these foreign bodies could be removed from the bladder without such great danger and pain. The operation by crushing, and removal without cutting, appeared to them to present the most practicable advantages, and they therefore devote their entire time to the improvement of this method for the removal of stone.
The method of crushing was first invented by a French surgeon many years ago; but, owing to his crude instruments, and the difficulty that was experienced in expelling the pieces of stone, the operation was seldom employed by surgeons. The improvements in these methods at the hands of Bigelow and Sir Henry Thompson, with those that have been made by our specialists, have resulted in our being able to present to sufferers with this disease, a means of cure which is, we are assured, the most successful known to modern medical science.
There have been so far in the history of the treatment of this malady by the new method of cure, one hundred and twenty-odd cases operated upon at the hands of prominent surgeons, all of which were with less perfect methods than that of our specialists, and there were but four deaths in this large number. By the advantages which are the result of further improvements by our specialists, we can assure you that this mortality is even less in our hands; in fact, approaches, as near as possible, to a perfect method of cure.
We think that in a moderately healthy subject, one in which the kidneys are not badly diseased as the result of irritation from the calculus, the operation is almost absolutely safe. The method consists in the crushing of the stone, and its removal from the bladder by means of small silver catheters attached to an apparatus which gently and perfectly removes, by suction, all the pieces which are thrown to the bottom of the bladder. This operation has now been performed in our institution in a very large number of cases with uniform success, and the cures have been effected in from six to eight weeks without a single unpleasant symptom arising during their progress. By this method it is not necessary to remove the entire calculus at one operation, if it is a large one. By the old cutting operation this was required, as the bleeding was great, and what was to be done had to be done immediately, or the patient would die from the hemorrhage. With the new method a part of the large calculus, or when several exist, one or two of them, may be removed at a time, after which the patient can rest and gain strength for the second; or, if necessary, for the third operation.
The largest stone removed by us in this way was one weighing between seven and eight hundred grains, for which three operations were required. It is necessarily performed under a mild anaesthetic, which prevents suffering and secures the perfect relaxation of the patient. In the case in which this large amount of stone was removed we feel certain that a cure could not possibly have resulted from a cutting operation, as the heart was seriously affected, and the physical condition of the patient so low, as the result of years of suffering, that death would have occurred while undergoing the operation. By carefully pursuing the new method, and not prolonging the sittings more than a few minutes each time, the entire stone was evacuated. The health of the patient constantly improved during the interval of three operations, which covered a space of seven weeks. This stone was as large as a hen's egg.
Small calculi or gravel are readily removed in a few moments' time by the new method. In no case is there any bleeding. Instead of a large, gaping wound being left after the operation, from which secondary hemorrhage may take place, or poisoning result from the irritation of decomposing urine, the parts are left in a healthy state with the surface unbroken. The stone, a constant source of irritation, is removed, and the health is speedily restored.
When it is impossible for the patient to visit us, a careful examination of the urine is made, and if gravel have been passed, these are carefully examined also. An idea of the composition of the stone is arrived at by this means, and treatment is directed to dissolve it. Success has commonly followed this method of treatment, when the stone has not been very large. With the gradual reduction of the size of the stone the irritation subsides, and the general health of the patient improves. (SEE TESTIMONIALS.)
CHRONIC ENLARGEMENT OF THE PROSTATE GLAND. (HYPERTROPHY.)
The prostate gland lies just in front of the base of the bladder, and surrounding the urethra, or urinary canal. Enlargement, therefore, of this body, if it be of considerable extent, causes it to encroach and press upon the base of the bladder, and to more or less constrict the urinary canal near the base or outlet of the bladder. The enlargement may be only slight, or the dimensions of the gland may be increased from the size of a large chestnut, its normal dimension, to the volume of a pullet's egg, or even to the size of an orange.
Hypertrophy of the prostate generally arises from causes which operate in a slow and permanent manner. Whatever has a tendency to produce a determination of blood to, and an engorgement of, this organ, is capable of producing the affection, an augmented flow of blood to the the part having the effect to increase the nutrition. Among the most frequent causes of this affection, are excessive venery, masturbation, disease of the bladder, stricture of the urethra, horseback exercise, gonorrhea, and the employment of strong, stimulating diuretics. Some of the worst cases that we have had to deal with have occurred in old men, and, in fact, the malady is more common to those advanced in life; but it is frequently produced in those of middle age by the causes enumerated.
Among the earliest symptoms of the disease is an uneasy feeling in the region of the base of the bladder. There is a more frequent desire to urinate than usual, and, in the course of time, this frequency becomes more urgent; still no particular notice may be taken of it, it being considered as "only a slight inconvenience." After several months, or it may be years, the discomfort increases, and nightly calls to empty the bladder become habitual. By and by the patient begins to find the discomfort of getting out of his warm bed very troublesome; still no notice to taken of it. He does not consider it worth his while to consult a doctor for "such a trifle." In the course of time the patient is obliged to get out of bed twice during the night instead of once. Afterwards, the calls become still more frequent and urgent; the inconvenience more evident; finally, pain is substituted for inconvenience, and then the doctor is consulted. Unless a specialist of experience be consulted, the bladder will most probably be examined, and medicine will be prescribed only to excite the kidneys to secrete more urine, which does harm instead of good; the disease slowly, but surely progressing. Patients often write us that they have had something wrong with the bladder for a number of years, having to urinate more frequently than they ought; sometimes having to do so three and four times during the night; in extreme cases even every half hour or so, and that they are not able to pass it freely, but only in small quantities, and attended with much pain. These symptoms are not always constant, but let up for a few weeks and then appear again. Things go on in this way for a year or two, perhaps, when the passage of the urine is completely shut off for several hours, and the patient is in great agony until the bladder is relieved by the use of the catheter. After such instrumental relief, for a day or two the urine may be natural again, coming at first, perhaps, in very small quantities, but by and by more freely. Then, after a week or two intervening, there may be another complete stoppage, attended, as before, with intense suffering, which will have to be again relieved by the use of an instrument.
The foregoing is a fair account of the usual progress of the disease and its symptoms. As the prostate gland becomes more irritated and inflamed from the natural progress of the disease, or from the irritation caused by the passage of instruments, or the employment of strong, harsh, stimulating diuretics, the urine becomes cloudy, and still later is found to have deposited during the night in the chamber utensil a quantity of thick, tenacious, and usually offensive mucus. There is apt to be more or less discomfort in the rectum, or lower bowel, produced by the pressure of the enlarged prostate upon it. Rarely, the first intimation of a large prostate occurs through a sudden retention of the urine, and the patient being under the impression that there was nothing wrong with the organ previously. Closely questioned, however, the information is elicited that there has been a long train of mild symptoms, similar to those that we have described, preceding the attack of retention of the urine. This shows the importance of early attention and proper treatment when such symptoms are manifested. However slight the inconvenience experienced, it should not be neglected. The disease should be brought under control at the outset by skillful and nicely-adapted treatment. Usually before a person suffers from toothache, the decay occasioning it has been gradually progressing without pain for from five to eight years. Just as the decay of the tooth may be arrested by the early attention of the dentist, so may prostatic disease by early attention be not only promptly relieved, but permanently cured.
Disease of the prostate being slow in its inception and progress, is also slow to yield even to the most skillful treatment. Being slow to develop, patients rarely seek assistance until the organ has become so large as to be seldom restorable to a size where mechanical means can be wholly dispensed with for relieving the bladder. Most surgeons are too much in the habit of depending on the catheter for the relief of the patient, and usually instruct the sufferer how to use it, telling them that this, the catheter, is to be their only doctor for life. Great as is the relief afforded by the catheter, which has often saved life, yet it is a fact that its frequent and prolonged use often renders disease of the prostate very intractable and often wholly incurable. Frequent use of the catheter, without any treatment to prevent the further enlargement of the diseased gland, or to reduce its size, permits the part to go on enlarging, and, besides, the constant use of the catheter irritates the prostatic portion of the urethra, causing thickening of the lining membrane, and sooner or later a more or less complete organic stricture of this canal, depending upon thickening of the lining mucous membrane, as well as upon the encroachment of the gland itself upon this canal. Besides, when the use of the catheter is once commenced, even when the enlargement is not very great, it is with the utmost difficulty that we have been able to induce patients to leave off its use. The bladder, becoming accustomed to its use, refuses to obey the will without this help. The irritation set up in the parts by the friction of the catheter causes inflammation and exudation in the lining membrane. This extends to the structure of the prostate itself and increases the hypertrophy or enlargement. It will, therefore, be seen how important it is to early resort to treatment to relieve the first manifestations of this affection. A disease of so delicate a nature, and one so often confounded with other maladies by inexperienced physicians, should only be intrusted for treatment to expert specialists of large experience in the management of this and kindred maladies.
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STRICTURE OF THE URETHRA.
Stricture of the urethra generally results from some specific disease of the urethra, but may be caused by sexual excesses, exposure, or strain, or by the practice of masturbation or self-abuse. It runs a course varying in time from a few days to many weeks or months, during which time the patient is often unaware of the real cause of his sufferings.
Commonly, the attention is first called to a stricture by a slight discharge, or smarting sensation, or the appearance of an undue amount of mucous deposit in the urine. Occasionally, some difficulty in starting the water, or a diminution in the size and force, or a twisting of the stream as it flows, is the first symptom. This passive stage is of variable duration. When skillful treatment is instituted at this stage of the disease, a speedy cure is easily effected without pain or danger. Any exposure, improper use of instruments, or irritating cause, may speedily give rise to the alarming symptoms due to closure of the urethra, from which fatal consequences may suddenly ensue.
This condition is illustrated in Fig. 2, which shows the hard and tough stricture which surrounds the soft mucous membrane that lines the urinary canal. When irritated or inflamed, as the result of a cold or other cause, the mucous membrane becomes swollen and thickened, and, as the stricture will not yield and enlarge, the result is that the urethra is almost completely closed, and it becomes impossible to pass the urine. Great pain is experienced, and the surgeon has to be called to draw off the urine with a catheter, which, at best, is a very difficult and painful operation, when the urethra is so irritable and constricted.
TREATMENT. In the earlier stages of the malady, relief is given by the skillful use of instruments for dilating the canal, or, where this fails by the operation of urethrotomy, for which we employ an improved and ingenious instrument, by which the stricture is readily and almost painlessly divided.
IMPROVED METHODS. Our surgeons have operated upon many hundreds of bad cases by a very ingenious and almost painless method, that requires no use of bougies in the after-treatment. This saves the patient an immense amount of pain and annoyance, and enables him to go home almost immediately after the operation.
The ordinary after-treatment, by dilatation with bougies, is very tedious, and often more painful than the operation itself, so that our peculiar method of treatment has been hailed with joy by those familiar with the old and unnecessarily-painful systems of treatment. Besides, our more improved method has been followed by far more perfect cures in every case operated upon.
In many of the cases coming under our observation and treatment, there have been several strictures, as illustrated in Fig. 3, which shows the urethra constricted at three different points, besides a congenital contraction at its mouth or meatus.
SPERMATORRHEA not infrequently results from stricture of the urethra, even when the affection is quite slight. Our attention was first called to this subject by the consideration of the numerous cases in which epileptic convulsions or "fits," and other serious diseases of the nervous system in children, have resulted from an unnatural contraction of the prepuce or foreskin, constituting what is termed phimosis.
Every surgeon of experience has met with many of these cases of reflex irritation. It occurred to us, that, inasmuch as these contractions of the foreskin give rise to nervous diseases of an alarming nature, may not an unnatural narrowing of the urethral canal, which must have exactly the same effect in retarding the flow of the urine, give rise to irritable nervous affections in adults. May not unnatural irritation and excitement of the sexual organs, so set up, cause loss of semen to occur during sleep, and consequent nervous and general debility?
It is a well recognized fact that the urethral canal should bear a certain definite and proportionate size to that of the penis, just as the length of the arm should naturally bear a certain proportion to the length of the body. In the case of some parts of the body, disproportionate development of the part may not give rise to anything further than unsightliness; but when we find the small size of the urethra retarding the free passage of the urine, then we may expect, if this condition is long continued, to find more or less irritation of the urethra and, perhaps, of the bladder, also. When there is a contraction of the urethra at its external orifice, or at any point along its course, unnatural pressure is put upon the urinary canal behind the constricted portion, and these parts must bear an undue strain during the passage of the urine.
It is a well established fact that improper diet, cold, exposure, and over-work exert a very powerful modifying influence upon the urinary secretion, frequently causing an acrid and irritating condition of this fluid. This condition, when associated with a contracted urethra, must result in irritation of the mucous membrane lining this canal back of the stricture, if long continued or frequently repeated. As an illustration, we have a hose pipe from which, by means of a small nozzle, water is expelled a considerable distance, but a great tension is put upon the hose behind the nozzle. If the pressure is increased greatly the hose will burst; but, if the small nozzle be replaced with a larger one, the projection of the stream will be quite as great, but all undue tension of the pipe is overcome and the danger of bursting is done away with. We have, in an unnaturally contracted urethra, a favorable condition for the development of disease in the urinary canal and adjacent parts of the generative organs. Irritation is set up in the urethra behind the stricture by undue strain in passing water, and the frequent reoccurrence of acrid urine, as the result of any of the causes we have already mentioned, this irritation keeps gradually increasing. It will be felt more during the periods when the urine is acrid, but may pass unnoticed even at such times. The seminal sacs and the prostate and Cowper's glands communicate with the deeper portions of the urethra by means of canals or ducts, lined with mucous membrane which is continuous with the urethral mucous membrane. Hence we can readily see that not only by reflex nervous irritation are those parts debilitated, through the contraction of the urethra, but the affection is apt to extend by continuity of the mucous membrane, and thus become more and more manifest, through symptoms of disease of the testicles, prostate gland and seminal vesicles, and these disorders become more and more seated the longer the morbid condition of the urethra is allowed to run on, until there may be an entire loss of the sexual functions, occurring at an age when there should be present the most vigorous manhood. From no other cause can we explain the common prevalence of disease of the deeper portions of the urethral canal and bladder, many times confounded with other diseases of the urinary and generative organs.
The following is the history of a case that fully illustrates the foregoing statements:
CASE 112,289. MR. O.C.E., SINGLE, 32 YEARS OF AGE.
He applied to us suffering from entire loss of the sexual function, with great nervous debility, and there was a thin slimy discharge from the urethra, and the usual symptoms of melancholia and weakness. He had lost all taste for business, and was extremely nervous, from the fact that he was engaged to be married, and felt that his condition would not permit it. On examination a contraction of the urethra was found at the point shown in Fig. 4, which had probably been present for years. He stated that he never had been just right in those parts, but had lived a virtuous life, had never had any venereal disease, and, hence, the true nature of his trouble had not been suspected. With the removal of the stricture there was an immediate improvement in his condition, which became more and more rapid, as his system gained strength and reaction became manifest. At the end of two months he wrote that he felt sound and well, and that he had experienced the most wonderful improvement in every way. His vital strength was fully restored, and he was most profoundly grateful.
Chronic inflammation of the bladder, sometimes called catarrh of the bladder, an affection that is elsewhere herein fully treated of, and chronic inflammation of the kidneys, and true Bright's disease, as well as prostatic disease, are all liable to result from strictures of the urethra. Hence, it behooves one suffering from this malady to have it promptly and skillfully treated.
FALSE PASSAGES. In very rare cases of impassable stricture, or in which fistulous openings, or false passages, have formed, through which the urine flows or dribbles away, we have resorted to the operation of perineal section with the most gratifying results. The cases requiring this operation are rare ones, in which death must generally result but for the relief afforded by the operation.
DANGEROUS USE OF INSTRUMENTS. The worst and most dangerous cases of stricture with which we have met, in a long and extensive experience, were rendered thus by the careless or unskillful use of bougies, catheters, or sounds. Many surgeons and physicians are most recklessly careless or unskilled in the use of these most dangerous instruments, as the many cases of false passage or stricture of the most painful and dangerous kind, caused or aggravated by their ignorant or improper use, sorrowfully testify.
DELAY DANGEROUS. By proper treatment of stricture in its early stages, all danger and pain are avoided, and a cure is effected in a very short time. In an extensive practice, in which we yearly treat hundreds of cases, we have never yet failed to give perfect and permanent relief from stricture, or diseased prostate or urethra, without the necessity of cutting instruments of any kind, when we have been consulted before injury of the urethra has been produced by improper use of instruments. Having specialists who devote their entire time to the study and cure of these diseases, we are thereby enabled to attain the highest degree of skill in the management of these cases.
GREAT SKILL REQUIRED. The urethra is a sensitive and delicate canal, and is surrounded by tissues the most delicate, and lined with mucous membrane which is highly vascular and filled with sensitive nerves. The introduction of any instrument is to be undertaken only when absolutely required, and, when necessary, it should be so skillfully and carefully effected that no pain or irritation can result. The slightest awkwardness is liable to cause an unnoticeable injury, which results in false passage or an effusion of plastic lymph around the canal, and as it organizes, the formation of the most troublesome organic stricture. The attention not only of sufferers, but also of the profession, is called to the remarkable success of our operation, perineal section, by which a cure of extremely bad cases of impassable stricture and false passages, or urinary fistulas, is effected in from thirty to forty days, and with very little suffering. That we have been successful in such cases must be considered as conclusive evidence that no case of stricture, false passage, or urinary fistula, is beyond the reach of our skill.
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TESTIMONIALS.
In a practice embracing the treatment of a vast number of cases of diseases of the Urinary Organs, it has been our good fortune to effect many remarkable cures. The experience gained in this field of practice has made our specialists skilled experts, and hence hundreds consult them as a last resort. In fact we seldom get a case, in this line, that has not been the rounds of the home physicians before applying to us for relief and cure. The cures, therefore, which we shall introduce here are the more remarkable because of the failure, in nearly every case, of other medical men to benefit or cure. They are not the every-day, ordinary cases met with in the general practitioner's rounds, but complicated, obstinate ones, which had generally been given up as hopeless before coming to us.
CASE 4A-3431. "WASTED TO A SHADOW." BLEEDING FROM KIDNEYS. A SEVERE CASE.
WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:
Gentlemen—I think it my duty to write to you concerning my case. In the year 1886 I was seized with inflammation of the bladder and passed nothing but thick blood, owing to heavy work, and I consulted a doctor and he said there was no cure for such a bad case; but he gave me medicine and it relieved me at the time I used it; and I took 16 bottles and I got worse and wasted to a shadow. I quit taking the medicine, and other complaints came, as rupture in the spermatic cord, for which I applied to you and soon got relief. And in 1891 the bladder disease made its appearance, and I wrote to the Invalids' Hotel and Surgical Institute and got no reply as our mails were stopped on account of snow drifts. I sent for the best doctor in Listowell and I still got worse, and he said I might live three or four weeks, but there was no stoppage of the disease. And I got so weak that I had to support myself by the furniture in my room; and I wasted down to 100 lbs. in two weeks; and I applied to your Institute and I received my medicine in a few days, and in two weeks I began to gather strength and now I am hearty and well and my weight is 145 lbs. I feel so thankful to the Medical Association and its Staff of skilled men. It is 15 months since I quit taking your medicines and no signs of the disease returning.
Yours gratefully, THOMAS S. BAILEY, Dorking, Wellington Co., Ont.
CASE 23A-877. INFLAMMATION OF THE BLADDER, WITH OTHER COMPLICATIONS. SUFFERED EXCRUCIATING PAIN IN URINATING.
For many years I suffered with inflammation of the Prostrate Gland and Bladder. It became gradually worse and I endured extreme pain, so much so that I was laid up for weeks at a time, and almost gave up in despair. I was persuaded to go to the Invalids' Hotel and Surgical Institute. I have never regretted following this advice. While there I submitted to an operation by their specialist. This was entirely painless and the result perfectly satisfactory. I left in a short time delighted, and have since been strong and well. I cannot speak in too high praise of this famous Institution; the rooms are large and pleasant, the food the very best, the attendants kind and attentive and the staff of physicians skillful and of large experience. I highly recommend all invalids to the World's Dispensary Medical Association. I feel confident that all the benefit to be derived from medical treatment is to be received at this Institution.
Yours truly, GEO. W. HEFFNER, Chicago, Ills.
CASE 2A-103. INFLAMMATION OF BLADDER, COMPLICATED WITH KIDNEY DISEASE.
WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:
Gentlemen—Having been a patient in your Invalids' Hotel for several weeks, I take great pleasure in telling other sufferers of my treatment which I received under your efficient staff of physicians, surgeons and nurses, and I will say with clear conscience that every care and comfort was given me that could be wished for. I am sure that your Institution is far in advance of the age, and would wish that every invalid could avail himself of the treatment that I received in your most excellently kept Invalids' Hotel. I cheerfully give this as my testimonial to individuals, friends and sufferers. My health is so fully restored that I look upon life with pleasure and comfort, whereas before I was a suffering, nervous invalid, unable to sleep and much of the time in torment. Wishing you success,
I am your friend and well wisher, M. MANHEIM, Georgetown, S.C.
CASE 859,143. BLADDER, RECTAL, KIDNEY AND LIVER DISEASE. "ENTIRE URINARY ORGANS ONE MASS OF SORES." "DESPAIRED OF CURE."
My disease was caused by the roughness and exposure incidental to the life of a miner, working in the gold mines of California and Montana. I had much of the time to work in water, with my clothes wet, which finally brought on a severe pain In my kidney, which ere long completely prostrated me. I employed and was treated by six different physicians, the best I could obtain in my section of country, and who while seeming to understand the nature of my disease, yet gave me no remedy that afforded me any real relief. I grew worse under the treatment of them all. The pain in the kidney left me, but immediately located in the bladder. My bladder became very painful and commenced to ulcerate and fill up. It seemed from the excruciating agony I suffered, that there must have been an abscess in either the kidney or bladder, and from the large amount of pus discharged at one time, it appeared to me that my kidneys, bladder and the entire urinary organs were one mass of sores and pus mixed with blood. I had to use injections of laudanum daily in the lower bowels to ease the pain and live. Was reduced by long suffering, looking for each day to be my last. I felt that no human power on earth could help me. No language can describe, and God only knows, the agony I suffered. From what I have already written, you may form some faint conception of my physical condition at the end of six years' treatment by the best medical aid I could get in the section where I was living. I also used for some time (with no benefit), "Warner's Safe Cure," and in fact, tried every means that I could hear of, but to no permanent relief. Such was my condition when I was led finally to consult and be treated by your Association, though I had but faint hope of obtaining any relief from any one. With the very best description I could give in writing of my case, and all the information you got from me, you would not undertake the case until you were further informed, and for which caution I sincerely thank you. You wrote me—"we are at a loss to definitely determine your condition. We have an opinion based upon the facts before us, but we feel that we must have a personal examination." In the condition I was then in, I could not have been kept alive to reach the first railroad station, which was only six miles from my house, and much less to travel to Buffalo. Indeed I wrote you, that if you would cure me for nothing, I was unable to go to you. In reply, you then advised me to take your "Special Remedies" until I could improve sufficiently to go to Buffalo for examination. Now this frank answer of yours, removed every doubt from my mind, and convinced me that you were honorable physicians. On March 10th, 1883, I began taking your "Special Remedies," as you prescribed them, and at the end of three years' constant treatment, I was improved sufficiently to go to Buffalo to your Institute, where I was examined as you required of me. When I reached your Institute, I was there carefully examined and received a month's treatment. When I reflect on my condition and my suffering when I first began to use your specifics, and see what I am now, I feel that no words can too glowingly express my gratitude to your Association for the physical benefits you have conferred upon me by your treatment of my despaired-of case.
SAMUEL C. TRACY Platteville, Wis.
DOUBLE VARICOCELE AND STRICTURE OF THE URETHRA.
WORLD'S DISPENSARY MEDICAL ASSOCIATION, 663 Main St., Buffalo, N.Y.:
Gentlemen—I have taken treatment from you for several months for nervous debility, and although I am not quite fully cured as yet, I have been greatly benefited, and believe, if I had come to you before I was duped and swindled by different quacks and was more dead than alive, I would to-day be a thoroughly well man.
I have also been to your Institute twice for surgical operations, and cannot too highly praise the Hotel, or the skill and care of the attending surgeons and nurses. They are gentlemen in every way and the Invalids' Hotel is just as represented.
I shall advise all suffering from chronic diseases to go to you for relief, as I have never seen any one there who was not cured or greatly benefited.
Very truly yours, CHRISTIAN HANSON, Esq. Austin, Mower Co., Minn.
CASE 23A-890. DISEASE OF THE URINARY ORGANS.
WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:
Gentlemen—I feel it my duty to give my testimonial in behalf of your grand Institution. I had an operation performed at your place two years ago for the relief of a very painful disease of urinary passage, and, thanks to your skill, I was cured, and have enjoyed the best of health since. I earnestly recommend your Institution to all who are suffering, and still further let me thank you for the kindness I received at the hands of everybody connected with the Institution. I am,
Respectfully yours, FRANK A. EMPSALL, P.O. Box 980, Pittsfield, Berkshire Co., Mass.
CASE 2A-208. RETENTION OF URINE. SUFFERED INTENSE PAIN.
WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:
Dear Sirs—To your favor of the 20th ult., would say that I can only speak in the highest terms of your Institution. After suffering for ten or twelve years with retention of the urine, and bladder difficulties, I can say that I found immediate relief at your hands. When going to your place, about six years ago, I was suffering with intense pain, loss of appetite, and unable to eat a good meal. I now weigh 170 lbs., do a good day's work and feel well in every respect. I am only too glad that I am able to praise your Institution, and can highly recommend it to any one who is suffering as I was. With great respect, I remain.
Yours very truly, P.J. HAMILL, Utica, N.Y.
CASE 80,115. ENLARGED PROSTATE AND CHRONIC CATARRHAL INFLAMMATION OF BLADDER.
Several years ago I had occasion to become an inmate of the Invalids' Hotel and Surgical Institute, No. 683 Main Street, Buffalo, N.Y. I was afflicted with an enlarged prostate and chronic Inflammation, or catarrhal condition of the bladder. I was largely benefited by the treatment I received there, and had I remained a little longer, as I was advised to do by the doctor who attended me, I should have fully recovered. I was so nearly cured that I did not think it necessary to remain longer, as I supposed nature would do for me what remained to be done, to effect a perfect cure. My business was urgent. I could not well remain longer. In this I made a mistake, I should have remained longer. I was seventy-two years old at the time. I bear willing testimony to the ability of the medical staff and the interest the doctors take in the welfare of their patients. The nurses and all the subordinates were very kind and seemed to vie with each other to contribute to the pleasure and happiness of the inmates of the Institute. One will find the Institute equipped with all the improvements known to modern science, for the promotion and restoration of health. It is impossible to do justice to its merits in a short article of this kind. Persons must go there and see and judge for themselves, of the wonders of this extraordinary medical establishment. If they cannot recover their health there, in my Judgment, it is of no use to go elsewhere.
ABRAHAM SCHELL, Knight's Ferry, Cal.
CASE 820,804. OBSTINATE AND COMPLICATED DISEASE.
WORLD'S DISPENSARY MEDICAL ASSOCIATION:
Gentlemen—Yours of July 12th to hand. I am only too glad to comply with your request. Having suffered for many years with a complication of diseases and feeling conscious that they were rapidly making serious inroads upon my constitution, and that I was speedily becoming unable and incapacitated to attend to my ordinary business. I resolved, after reading a number of testimonials from your patients, to place myself under your treatment at the Invalids' Hotel and Surgical Institute. With heart-felt gratitude I can truthfully say I am relieved of my trouble. I most cheerfully and earnestly recommend this Institution to all who are afflicted with chronic and painful diseases, no matter of what nature. During my stay there I saw some wonderful cures and surgical operations.
Yours truly, JOHN H. SMITH, Deckertown, Sussex Co., N.J.
CASE 520,425. COMPLICATION OF DISEASES.
Without solicitude or hope of pecuniary reward, with heart-felt gratitude and a desire to aid my fellow-man to health and happiness, allow me to state, that as an inmate for more than a month of the Invalids' Hotel and Surgical Institute at No. 663 Main Street, Buffalo, N.Y., I feel warranted in its highest recommendation. While there I saw and talked with a great number of people who came there as a last resort, to be cured of almost every chronic disease to which flesh is heir, and they were unanimous in their praise of the Institution and the skilled specialists who constitute its professional staff.
ANDREW HOLES, Moorhead, Minn.
CASE 654,500. DISEASE OF KIDNEYS AND OTHER COMPLICATIONS CAUSED BY EXPOSURE AND MALARIA.
WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:
Gentlemen—Having spent a short period of time at the Invalids' Hotel and Surgical Institute, No. 663 Main Street, Buffalo, N.Y., I must say I found it fully equal in every respect to the claims made for it by the proprietors. It was filled with invalids who were under the care of a corps of physicians and surgeons and the fact that all the sick people appeared to be improving, and that they were both cheerful and hopeful, and that they all spoke well of the Institution and of its doctors, was calculated to inspire confidence in one who went there himself to be treated. The greater number of these cases, as far as I was able to learn, were chronic and of a complicated character. They represented a wide range of the States and Territories of the Union, and had in each exhausted the resources of the home physicians. Having myself been treated by your Faculty for a complication of troubles induced by exposure and malaria, I feel that I owe my restoration to health to your skill and devotion, at a time when I was unable to perform labor and was much discouraged, and had failed to obtain relief elsewhere. You are at liberty to make any use you may desire of this communication.
Very respectfully yours, J.W. DEAN, Chariton, Putnam Co., Mo.
CASE 620,230. DIABETES AND INFLAMMATION OF BLADDER, GIVEN UP BY HIS HOME DOCTORS AS SURE TO DIE IN A FEW WEEKS. RESTORED TO ACTIVE WORK ON HIS FARM.
WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:
Gentlemen—I received your kind letter the 12th, and was glad to hear from you and have no objection to your making use of my name in any way to help the sick and suffering, for I know what it is to be sick. I was sick for seven years; could not do anything; was visited by seven doctors and was treated by four, and was given up to die by one of the best doctors of Russellville. He said I could not live longer than fall. He treated me for Sugar Diabetes, while the rest said I had inflammation of the bladder. After giving up all hopes of being cured at home, a friend got me to write to Dr. Pierce's Institution and after corresponding: awhile I decided to go and be treated. I was there one month and I never was cared for or treated more kindly by any one. No parents could have been better to their sick children. I cannot speak too highly of the Institution, and I believe I would have been in my grave to-day if I had not gone and been treated.
I feel great pleasure in expressing to you my sincere thanks for the cure that has been effected in my case, by your very skillful treatment, whereby I am now entirely and I trust permanently cured from a dangerous disease, which had defied the utmost skill of all former medical attendants for the past five years, and from which I had despaired of being: relieved. I am happy to state that my health is so good since taking the month's course of treatment at your Institute, and, the home treatment since my return, that I am now able to carry on the work of my farm.
I would cheerfully recommend all persons requiring medical or surgical aid to consult you at the earliest possible opportunity, as I know by personal experience that the facilities cannot be surpassed for treatment of all classes of chronic diseases.
Most gratefully yours, J.D. PARKS, Homer, Logan Co., Ky.
P.S.—I have always recommended my neighbors to your Institution and was the cause of F.M. Brasher taking treatment, who was cured after two doctors gave him up. J.D.P.
CASE 820,426. COMPLICATION OF DISEASES. A GRATEFUL PATIENT'S WORDS OF PRAISE.
WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:
Gentlemen—Having been in your Institution as a sufferer from two distinct chronic diseases of years' standing, and having been placed under the charge of your specialists, I was speedily relieved of my afflictions. The Invalids' Hotel is a place as much like home as it is possible for such an institution to be. The physicians and surgeons are all expert specialists and thoroughly efficient; the nurses are very competent, attentive and kind; and, in fact, the whole personnel of the Invalids' Hotel endeavor to do their best to make the patients feel like being at home. I always felt while there as if I was one of the family. I gladly recommend your Institution to all persons who are afflicted with any kind of chronic disease, for from my own experience I know the professional staff will do all which they promise to do. Please accept my thanks for the speedy benefits and perfect cure of my diseases, and I think your Institution is worthy of the highest endorsement.
Yours truly, WILLIAM HENKEL, No. 1917 Congress Street, St. Louis, Mo.
"A question of life or death!"
CASE 2A-107. STONE IN BLADDER. CASE SIMILAR TO THAT OF COL. ELLIOTT F. SHEPARD, WHO DIED IN NEW YORK WHILE UNDERGOING AN OPERATION.
Gentlemen—I am seventy-seven years of age and have resided in Erie for sixty-two years, and for thirty-six years have been an elder in the First Presbyterian Church. During four or five years I suffered from a painful affection of the bladder; the severity permitted neither freedom from pain by day nor calm repose by night. Meanwhile, I consulted leading physicians and visited numerous health resorts. Neither time, means nor effort were spared that I might be free from pain. Relief came unexpectedly. A signal act of Providence, that should be acknowledged daily, brought your Institution to my notice, though I had then no acquaintance with any one connected with it. With me it was a question of life or death. Up to last March I was in a condition of unendurable torture. I knew that at my age, after the months of pain already borne, that any operation would be serious, perhaps fatal. Accordingly, I arranged my temporal affairs and carefully "set my house in order." On the 13th of March last, I started for Buffalo to your Institution. Still uninformed as to the cause of my trouble, I submitted to a searching examination, as to my habits, constitution, parentage, the age and cause of death of my parents, and other facts, from which a tolerable biography could have been prepared. All was kindly intended. Their aim was to locate my ailment and then to determine my ability to undergo an operation. Having found a stone in the bladder, they advised that it be crushed and extracted. By a strange coincidence as this was announced, I learned of Col. Elliott F. Shepard's death under an operation for the same disease. He was many years my junior, and seemingly far better able to undergo the operation. Still, in my desperation, I determined to go on. During five days, I was under treatment for the coming operation. On the 18th of March the stone was crushed and extracted. It was a complete success. Of the consideration, tenderness and skill of the surgeon and his assistants, I cannot too strongly speak. Of the gentle and assiduous nurses, the system and completeness of the whole establishment, as it moved along as one harmonious whole, in all its departments, I cannot sufficiently express my admiration. I am now relieved of a state of torture, and restored to health and happiness equal to any period of my life. This I say with sincerity and emphasis. Since then I have gained twenty-two pounds in flesh. I wish my words could reach the ear of every one similarly affected, throughout our land, to banish all doubts and take advantage of the science, skill and pleasant surroundings so happily blended in your Institution, for the removal of pain and the mitigation of distress.
DAVID S. CLARK, Erie, Pa.
CASE 520,123. STONE IN BLADDER. 1200 GRAINS OF STONE REMOVED WITHOUT CUTTING. PASSED BLOOD IN GREAT QUANTITIES FROM THE BLADDER. DOCTORS AT HOME (AS USUAL) DISCOURAGED HIM FROM COMING TO US.
WORLD'S DISPENSARY MEDICAL ASSOCIATION:
Gentlemen—I am glad to make public the wonderful cure that you accomplished in my case. For ten years I was a sick man, and during three years I suffered so much that life was a burden. My business had to be given up and the torments were something that could not be described. Every little while I had to urinate, and each time suffered a spasm of pain, like a knife thrust; the use of a catheter was painful and often it took long and painful trials before the water could be drawn off. I passed blood, in quantities at times. When I went to your place we had given up hope of a cure, and relief was all that I looked for. My doctors at home discouraged me. I spent four weeks in your Invalids' Hotel, and now at the age of sixty-seven years am sound and hearty as any one, work from five in the morning until seven at night. I manage a large and active business and enjoy life. I cannot express my high praise of your Institution. Your doctors are skillful and the nurses all kind and good. All understand their business and attend to it. I came home a new man and cannot say enough for your praise, and to express my thanks for the wonderful cure and comfort I have enjoyed.
Yours, JAMBS VINE, SR.
P.S.—You removed a stone that weighed over 1200 grains from my bladder, without cutting. The operation gave me complete relief. While there and since, I have seen a great many skillful cures done by you.
J.V., SR., St. Catherines, Out.
CASE 620,610. STONE IN BLADDER—WEIGHT 530 GRAINS—SUCCESSFULLY REMOVED WITHOUT CUTTING. NEIGHBORS TOLD HIM HE WOULD BE "BROUGHT HOME IN A BOX."
WORLD'S DISPENSARY MEDICAL ASSOCIATION:
Gentlemen—Seeing the picture of the Invalids' Hotel and Surgical Institute in our local newspapers, called to my mind the treatment I received there in 1887. I had been suffering for ten or twelve years with bladder trouble, and our home physicians did not seem to understand the cause or the trouble, and I finally corresponded with your faculty, and their advice was to come and have an examination. I had been a great sufferer and was so weak that I could hardly walk from the hotel to the depot, and those who saw me start said that I would be brought home in a box. Soon after my arrival an examination revealed a stone in my bladder. After a few days' treatment to strengthen up the system, the stone was taken out, weighing 530 grains. Four or five others were afterwards taken out of smaller size, and I am still alive. Will soon be seventy-six years old, and I cannot speak too highly of the care and attention I received from the physicians and nurses while there. Everything that was provided was of the best; good food, glean apartments; and no better place can be found for treatment of the many diseases they advertise to cure.
Anyone suffering from bladder or kindred trouble can find relief at the Invalids' Hotel, Buffalo, N.Y.
Respectfully, C.A. CHURCH, New Berlin, N.Y.
CASE 620,258. STONE IN THE BLADDER—GREAT SUFFERING FOR YEARS—HEART-FELT GRATITUDE.
WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:
I would not be a true man If I did not acknowledge at this time (as I should have done long ago), with words of gratitude, the wonderful relief I received at your Institution five years ago. It affords me the greatest pleasure to say to you and to the world at large, that the treatment and operation I received at your Institution was an entire success and a miraculous cure. After twenty-five long years of suffering such as few people endure, caused from exposure while in the military service of the United States, I contracted kidney and bladder disease, which shortly afterwards resulted in the formation of a calculus or stone. I experimented with medicines. Special Prescriptions, etc., from some of the most eminent physicians in the world, in fact everything that promised relief and help for my kidneys was used, but received no relief, until the bladder discomfort became unendurable. As a last resort, knowing full well that life with me would be very short unless I could receive immediate relief, I went to your famous Institute, where I was treated and operated upon and a large stone was removed from the bladder. The old method of cutting, which is so dangerous, was not employed, but the new and painless process of crushing; this process was an agreeable surprise to me, no pain and no risk, as in the old method of cutting. From the day of the operation I began to improve, and in a few weeks thereafter I returned home to my wife, family and friends, a well and happy man, and I have spent the last five years with ease, comfort and pleasure—a living, walking testimonial for your renowned Institute. Believe me, when I say that words fail me to express to you my sincere gratitude for your marvelous and almost miraculous cure effected in my case. I feel sure no invalid could receive more skillful and kindly attention anywhere in the world. I would urge every sufferer to take treatment at the Invalids' Hotel and Surgical Institute, believing it to be the most skillful, and feel sure that it is the most advanced of the age. |
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