HEMORRHAGE, or bleeding, may generally be controlled by a compress, tourniquet, flexion of the joint, or styptics. A compress consists of several folds of cloth laid upon a wound, the edges of which have been brought together, and made secure by a moderately tight bandage.



A tourniquet may be extemporized by rolling a handkerchief into a cord and tying it around the limb, over a compress, between the wound and the heart. A stick should then be thrust between the handkerchief and skin and twisted around several times, until the pressure is sufficiently great to arrest the circulation of the blood in the wounded part. A representation of this operation may be seen in Fig. 1.



Flexion of the joint, as represented in Figs. 2, 3, and 4, is adapted to many cases of hemorrhage. As water cannot flow through a rubber tube bent at a sharp angle, so the acute flexion of a limb prevents the free flow of blood through the arterial tubes.

In some cases, styptics may be directly applied to the wounded tissues. Cold acts as a powerful styptic, and may generally be made available for arresting hemorrhage.

POISONED WOUNDS. The treatment of these should chiefly consist in the prevention of the spread of the poison. This may be done by tightly applying bandages above the wound and scarifying or sucking the parts. Nitrate of silver may then be used and the ligatures removed. Alcohol, in any form, is an antidote to snake poison. For the stings of insects, apply aqua ammonia, fresh earth, raw onion, plantain, or spirits of turpentine.

FRACTURES AND DISLOCATIONS.

The treatment of injuries received from the fracture of bones and the dislocation of joints should never be attempted by the inexperienced, nor should the management be left to incompetent physicians but skillful surgical aid should at once be summoned.

SPRAINS.

A sprain consists of a sudden and forcible stretching of the ligaments and tendons connected with a joint, without there being any dislocation. It is attended with severe pain and is followed by rapid swelling.

The treatment should consist of measures to prevent inflammation, promote absorption, and restore a healthy action. The affected part should be kept at rest in an elevated position, and hot or cold water applied frequently. If there is much inflammation, fomentations of hops may be used. The Compound Extract of Smart-weed is an excellent application.

When the acute symptoms have disappeared, absorption should be favored by systematic rubbing and the application of stimulating liniments, or by the use of a well-adjusted bandage. Passive motion may be resorted to gradually and the subject may use the joint moderately. Should any stiffness remain, warm salt water douches should be employed and the Extract of Smart-weed applied once a day.

BRUISES.

Bruises or contusions are caused by falls, wrenches, or blows from blunt instruments, without breaking the skin. The soft tissues are lacerated and blood is poured out into them, constituting ecchymosis. The discoloration passes through various shades from a bluish-black to a violet, a green, and finally, a yellow.

If the bruise is severe, the affected part should be kept at rest and frequently bathed with the Compound Extract of Smart-weed or the tincture of arnica. If inflammatory symptoms supervene, fomentations and poultices should be applied.

FOREIGN BODIES IN THE NOSE.

Foreign bodies, such as beads, peas, coffee-grains, and small gravel-stones are occasionally introduced into the nostrils of children, becoming fastened there, and causing great anxiety and alarm. If allowed to remain, they generally cause inflammation and suffering.

Such bodies may generally be washed out by gently injecting a stream of tepid salt water with a syringe or Dr. Pierce's Nasal Douche. In no case should force be used. If these means fail, a competent surgeon should be consulted.

FOREIGN BODIES IN THE THROAT AND AIR-PASSAGES.

Foreign bodies are generally arrested so high up that they may be seen by simply depressing the tongue, and removed with the finger or a pair of forceps. The head should be thrown back in such a position as to cause the chin to project as little as possible beyond the prominence known as Adam's apple, in order that the finger or forceps may be readily introduced and the body released and ejected. When the foreign bodies are so small as to pass out of sight in the larynx, windpipe, or esophagus, it is generally difficult to extract them, and the services of a surgeon are required. Fortunately, however, there is not much immediate danger from suffocation in such cases.

DROWNING.

Recovery from drowning sometimes occurs when life is apparently extinct. The treatment, however, should be immediate and energetic, and should be given in the open air, unless the weather be too cold.

TREATMENT. The patient should be gently placed upon the face with his wrists under his forehead. The tongue will then fall forward and the water run out of his mouth and throat, while the windpipe, or air-passage, will be free. To restore respiration, he should be instantly turned upon his right side, his nostrils excited with snuff or ammonia, and cold water dashed upon his face and chest. If this operation prove unsuccessful, replace the patient upon his face, care being taken to raise and support his chest, turn the body gently on the side and quickly again upon the face. Alternate these movements about every four seconds, and occasionally change sides. When the body is turned on the face, gentle but efficient pressure should be made along the back, between the shoulder blades, to assist in forcing the air out of the lungs, but this pressure ought to be removed before the patient is turned back on his side. Persistently repeat this operation, and success will often be the reward. As soon as respiration is established, warmth may be promoted by the application of warm flannels to the body and bottles of hot water to the stomach, armpits, thighs, and feet. During the entire process of restoration, the body should be thoroughly rubbed upwards. Turning the body upon the back or handling it roughly should be avoided. The person should not be held up by his feet, or be rubbed with salt or spirits. Rolling the body on a cask is improper, and injections of the smoke infusion of tobacco are injurious. Avoid the constant application of the warm bath, and do not allow a crowd to surround the body.

FAINTING.

When a person faints, he should be allowed to remain or be placed in a recumbent posture, and his clothing immediately loosened. The extremities should be rubbed, the patient permitted to have plenty of fresh air, and, if at hand, ammonia or camphor should be applied to the nostrils.

BURNS AND SCALDS.

The danger arising from burns and scalds depends not only upon the extent of surface involved, but also upon the depth of the injury. Burns are most dangerous when occurring upon the head, chest, or abdomen.

TREATMENT. Soothing applications, and those which will exclude the air, should be made. Grated potato, poultices of slippery-elm, sweet oil, cotton saturated in a mixture composed of two or three grains of carbolic acid and two ounces of glycerine, and linseed oil and white lead, are all beneficial for the treatment of burns. If internal treatment be necessary, it should be given under the direction of a competent physician.

SUN-STROKE.

In cases of sun-stroke, the patient should be at once removed into the shade. If the face is flushed, apply cold water to the head and neck, and mustard to the feet. The body should be bathed in tepid water and the head slightly elevated. If the countenance is pale, the symptoms denote exhaustion, and the patient should be kept in a recumbent position, the extremities rubbed, camphor and ammonia inhaled, mustard applied to the spine, and stimulants, such as brandy or whiskey, should be administered.

POISONS AND THEIR ANTIDOTES. + POISONS. ANTIDOTES. + ACIDS. Acetic Acid. Alkalies carbonate of soda and potash also Citric Acid. lime and magnesia are antidotes to these Muriatic Acid. poisons. As soon as the acid is neutralized, Tartaric Acid. mucilaginous teas, such as flax-seed, gum arabic, or slippery-elm, may be given. Sulphuric Acid Soap, in solution, or magnesia will counteract (Oil of Vitriol). its influence. Water should not be given as it causes great heat when mixed with this acid. Nitric Acid Lime-water, carbonates of lime and magnesia (Aqua Fortis). in solution, are the only antidotes. Give Oxalic Acid. mucilaginous drinks. Carbolic Acid. There is no special antidote. Oil, glycerine, milk, flour and water, white of eggs, magnesia, and flax-seed tea may be used. Prussic Acid. Ammonia, by inhalation or in solution, may Laurel Water. be used. Apply a cold douche to the head. Oil of Bitter Almonds. These agents are speedily fatal. + ALKALIES. Liquor of Ammonia. Vegetable acids, such as vinegar, lemon-juice, Water of Ammonia. citric and tartaric acids, neutralize this Muriate of Ammonia. poison. Liquor of Potassa. All the fixed oils, such as linseed, castor Nitrate of Potassa and sweet oil, also almonds and melted lard (Saltpetre). destroy the caustic effects of these poisons Carbonate of Potassa Mucilaginous drinks may be given. (Pearlash). Salts of Tartar.



+ - POISONS. ANTIDOTES, + - IODINE. Starch, wheat flour mixed with water, In its whites of eggs, milk, and mucilaginous different forms. drinks are excellent antidotes. + - VOLATILE OILS AND AGENTS. The same antidotes as in case of poisoning Creosote with iodine may be used in this, or the (Oil of Smoke). stomach may be evacuated with an emetic or a Oil of Tar. stomach-pump. Oil of Turpentine. + - A powerful emetic of white vitriol or mustard should be given at once, cold should be ALCOHOL. applied to the head, and the extremities vigorously rubbed. + - ANTIMONY AND ITS COMPOUNDS. If vomiting has not occurred, induce it by tickling the throat and giving large draughts Tartar Emetic of warm water, after which administer Butter of Antimony astringents, such as infusions of galls, oak bark, Oxide of Antimony. Peruvian bark, or strong green tea. + - ARSENIC AND ITS COMPOUNDS. White Arsenic. Oils, or fats lard, melted butter, or milk Yellow Sulphuret of should be given, then induce vomiting with Arsenic sulphate of zinc, sulphate of copper or Red Sulphuret of mustard; fine powdered iron rust or magnesia Arsenic may be given every five or ten minutes. King's Yellow. Mucilaginous drinks should be given as soon Fly Powder. as the stomach is evacuated. Arsenical Paste. Arsenical Soap. Scheele's Green. Paris Green. + - COPPER AND ITS COMPOUNDS. Avoid the USE of vinegar. Give albuminous substances, such as milk, whites of eggs, wheat Blue Vitriol flour in water, or magnesia; yellow prussiate Verdigris. of potash in solution may also be given freely.



- POISONS ANTIDOTES. - LEAD AND ITS COMPOUNDS. In lead, or painters' colic purgatives and anodynes may be given, together Acetate of Lead with large doses of iodide of (Sugar of Lead) potassium. White Lead. Red Lead. Litharge. MERCURY AND ITS COMPOUNDS. Albumen in some form should be given; if the poison is not Corrosive Sublimate. absorbed, follow with a mustard White Precipitate. or lobelia emetic. Red Precipitate. Calomel. - ACRONARCOTICS. The general treatment indicated for Ergot this class of poisons, is to Black Hellebore. evacuate the stomach with a Veratrum Viride stomach-pump or an emetic composed (American Hellebore). of fifteen or twenty grains of Aconite. sulphate of zinc or copper, or large Foxglove. doses of mustard, repeated every Gelseminum. quarter of an hour until the full effect is produced. Belladonna. Morphine, sassafras, iodine, and Stramonium. stimulants. Nux Vomica. Large doses of camphor, chloroform, Strychnia. and tobacco, may all be beneficial. Poison Oak. Muriate of ammonia, in solution, may Poison Vine. be applied externally, and from ten to fifteen grains given internally; soda is also useful. - NARCOTICS White Henbane. Sassafras may be used as an antidote Opium. for henbane. Belladonna is an antidote of opium; cold water should also be applied to the head of the patient, and the extremities should be well rubbed. - ANIMAL POISONS. Excite vomiting by drinking sweet oil. Sugar and water, milk, or Spanish Fly. linseed tea in large quantities, and Potato Fly. emollient injections are valuable.



POSTERIOR SPINAL CURVATURE.

(HUMPBACK.)

Posterior curvature of the spine, sometimes known as Pott's Disease, occurs most frequently in children, and is generally developed before the seventh year. Children of a scrofulous diathesis are especially liable to this affection. It is generally due to disease of the inter-vertebral cartilages and bodies of the vertebrae. It comes on in a slow, insidious manner, hence, it often makes serious inroads upon the spine and system before its character is even suspected.



Generally the first point of invasion is the cartilaginous substances between the bodies of the vertebrae, beginning with inflammation, and finally resulting in ulceration and a breaking-down of the cartilages. It next invades the vertebrae themselves, and producing caries, or death and decay of the bony substance, which softens and wastes away, as shown in Fig. 1. The vertebrae become softened and broken down, and weight of the body pressing them together produces the deformity known as "humpback." (See Fig. 2 and Fig. 3.)

SYMPTOMS. Among the various symptoms present in the earlier stages of the disease, and during its progress, we deem it necessary to mention only a few of the more prominent ones. While the patient is yet able to go around, the disease manifests itself by occasional pain in the bowels, stomach, and chest. Often there is a hacking cough, nervousness, lassitude, and a generally enfeebled condition of the whole system. The patient is easily fatigued; there is apparent loss of vitality, impaired appetite, a feeling of tightness across the stomach and chest, gradually declining health, and loss of flesh and strength, torpidity of the liver, deficient secretions, constipation, and morbid excretions from the kidneys. The victim, in passing chairs, tables, and other objects, instinctively places his hands upon them, and, as the disease progresses, when standing, leans upon some support whenever possible. In walking, he moves very carefully and cautiously, with elbows thrown back and chest forward, to assist the body in keeping its equilibrium. The body being kept in an upright position, the patient bends the knees rather than the back in stooping, as illustrated in Fig. 5, and the body is frequently supported by the hands being placed upon the thighs or knees. Sudden movements or shocks cause more or less pain.

The development of the disease then becomes rapid; suffering increases, and pain about the joints and lower extremities and muscles of the posterior part of the pelvis is experienced; numbness and coldness of the extremities are felt; locomotion becomes more difficult, and a slight projection is observed upon the back. Even in this somewhat advanced stage of the disease, when the symptoms are so apparent, many cases are shamefully neglected because an ignorant adviser says it is nothing serious and that the patient will outgrow it. The pain and tenderness not always being in the back, the inexperienced are very often misled as to the true character of the trouble. This distortion or deformity of the back now becomes painfully prominent; the diseased vertebrae quickly soften and waste away; the pressure upon the spinal cord increases, and paralysis of the limbs supervenes; the power of locomotion is lost, and, at last, the danger is realized and the struggle for life begins.



Thus, through ignorance, neglect, and improper treatment, the poor, helpless victim is doomed to a life of hideous deformity and suffering. We would, therefore, urge upon parents whose children are afflicted with this terrible disease, the great importance of placing them under the care of surgeons who have for many years made the treatment of such cases a specialty, and who have every facility and all necessary surgical appliances for insuring success in every case undertaken.



TREATMENT. The great essentials for the successful treatment of disease and deformities of the spine are first, a thorough knowledge of the structure and parts involved by the disease; secondly, the adjustment of mechanical appliances perfectly adapted to the requirements and necessities of each individual case, and the proper use of our system of "vitalization," applied to the spinal muscles to strengthen the weaker and relieve the undue contraction of the stronger. For many years our specialists have experimented, and have given the various appliances in common use in these cases most thorough and practical tests, and have found them very defective, being generally constructed upon wrong principles. The physician who sends to a mechanic for an appliance, such as are now made in the shops of most instrument makers, and uses the same, is doing himself an injustice, and barbarously torturing his patient by forcing him to wear an apparatus which is heavy, clumsy, and inevitably injurious, instead of being beneficial in its results. In the treatment of diseases and deformities of the spine, there should be no compromising; the appliance that fails to give complete support should not be worn. In our treatment of these maladies we employ only appliances which are constructed under the personal supervision of our specialists, upon principles dictated by common sense and the actual necessities of the case. We do not confine the body in an iron jacket. Our apparatus is light, yet durable, and is worn by the most delicate children without pain or inconvenience. It gives proper support to all parts, and is so nicely adjusted as to produce pressure only upon those points which should receive support, leaving the muscles of the spine freedom of action, thereby assisting in their development. In many hundreds of cases treated by our specialists, the disease has been entirely cured and the deformity removed. After seeing the patients and adjusting the appliances, they can generally be treated at their homes.

LATERAL CURVATURE OF THE SPINE.

(CROOKED BACK.)



This deformity appears more frequently in anaemic persons, in whom the flexibility and elasticity of the muscles are weakened, than in those of a plethoric habit. It is generally contracted during youth, between the ages of twelve and eighteen. Persons of sedentary and indolent habits are especially liable to this deformity, hence, girls are most frequently its victims. It is never seen among the natives of tropical countries who habitually live in the open air, and seldom among the barbarous races of northern latitudes. A distinguishing feature of the American Indian is his erect carriage. The primary curvature is generally toward the right side, as represented in Figs. 6 and 7. Figs. 8 and 9 show the disease in a more advanced stage. The ribs are thus forced into an unnatural position, and the vital organs contained in the cavity of the chest are compressed or displaced, thus distorting the form of the whole upper portion of the body.



SYMPTOMS. The first indication of lateral curvature of the spine is a marked projection of the right scapula, or shoulder-blade. It is sometimes first observed by the dressmaker, or, accidentally, while bathing. The right shoulder is slightly elevated, while the left hip is depressed and projects upward. If not corrected while in its earlier stages, it progresses very rapidly, and a second curvature is developed. The symptoms vary in different cases, and in the early stages are somewhat obscure and undefined, but generally the patient feels a sense of uneasiness, languor, stupor, and nervousness, loss of energy and ambition, general debility, poor appetite, gradually declining health, loss of strength and flesh, and, as the disease progresses, a slight elevation of one of the shoulder-blades is noticed, as well as the deviation of the spine to one side. The curve, or distortion, of the spine increases more rapidly as the body becomes heavier, the spine often assuming the shape of the letter S, and, from compression by torsion of the vertebrae and distortion of the ribs, the vital organs are encroached upon, causing serious functional derangement of the heart, lungs, liver, and stomach, producing, as its inevitable consequence a list of maladies fearful to contemplate.

CAUSES. In rare instances, the lateral curvature of the spine is due to defects of certain bones of the pelvis or limbs. Cases are recorded in which this deformity was caused by diseases of the abdominal organs, but, as we have intimated, it is generally due to a lack of tonicity of the muscles, or, as a late writer has expressed it, "Want of correspondence in the antagonism of those muscles which control the motions of the spinal column." Habitual sitting or standing in a leaning posture, or standing upon one foot, thus constantly using one set of the muscles of the back, while the other becomes enfeebled by the lack of exercise, is a common cause of this deformity. The habit which so many school-girls contract of drawing up one foot under the body while sitting, often produces a lateral curvature of the spine.

TREATMENT. No disease or deformity of the spine is so easily cured and perfectly corrected, if the proper plan of treatment is pursued. To correct this deformity, many ingenious forms of apparatus have been devised and invented by our specialists, which should be carefully adjusted to each individual case. In addition to this, our method of treatment by "vitalization," and by mechanical movements and manipulations, is almost indispensable in these cases. It never fails to give relief, and, if properly pursued, invariably results in a permanent cure.

DEFORMED FEET, HANDS AND LIMBS.

There are thousands whose feet, hands, and limbs are almost entirely useless, besides having an unsightly appearance. Their condition has been helpless so long, their treatment so varied, and their hopes of relief or cure have been so often disappointed, that few can believe the truth of our statement, when we positively assert that we can correct and cure nearly all cases of talipes, club, or crooked feet and deformed hands, and make them as perfect in appearance, and as useful in action, as feet and hands which have never been deformed. While this may seem miraculous, or even impossible, to those who are unacquainted with the wonderful improvements and rapid progress made in this department of surgical science, it is attested and verified by living witnesses whose feet and hands were once deformed and useless, but which have been made perfect by our new and improved method of treatment. We do not make these statements in a spirit of vain boastfulness, but having devoted many years to improving and perfecting surgical appliances and apparatus, and having had practical experience in the successful treatment of thousands of cases, we do say that our manner of treatment is original and employed only by us. We entirely ignore the ineffectual methods usually employed in such cases. Our treatment causes no pain, and little inconvenience, yet the curative results are speedy and certain, and a hundredfold more satisfactory than those obtained by any other course.



We have most thoroughly tested all the best forms of treatment heretofore devised and employed in this class of diseases, and have adopted the best features of all the various methods heretofore pursued. We have combined these with our own improvements and, as the result, we have perfected a thorough and efficient system of treatment, based upon scientific principles.



* * * * *



MECHANICAL AIDS

IN THE TREATMENTS OF

CHRONIC DISEASES.

We have, in different parts of this work, referred to a large variety of ingeniously devised machinery and apparatus employed at the Invalids' Hotel and Surgical Institute, in the treatment of chronic diseases. Although we can, on paper, give but a meagre idea of the variety and adaptability of these valuable mechanical appliances, yet we will endeavor to illustrate and explain a few of our machines for the application of transmitted motion.



Fig. 1 represents a machine, called the Manipulator, which transmits motion through suitable attachments, which are adjustable by means of the ratchet G, so as to reach all parts of the body. It is equally available for applying motion to the head, feet, or any intermediate part of the body.

B, B are rubbing attachments, with two opposing elastic, adherent surfaces, between which an arm or a leg may be included. These have alternate reciprocating action from the rock-shaft H, and are made to approach each other, and press the included part at the will of the patient. This is sometimes called the double-rubber, and is made detachable if desired.

A is the lever, by which the two parts of the double-rubber are made to compress the arm or leg.



D is a single attachment for rubbing. It may be connected at either side of the machine, so as to present the rubbing surface in four different directions, as may be most convenient. It will act perpendicularly, horizontally, or diagonally, and from below or from above the part receiving the action, according to requirements. The shank of the rubber may have any special form to suit special cases.

C is the foot holder. It communicates to the leg the semi-rotary or oscillating motion of the rock-shaft. It may be attached to either end of the rock-shaft.

E is the hand holder, which, grasped by the hand, communicates motion to the arm, shoulder, and chest; or the hand may be inserted passively, when the effect of motion is more confined to the hand and fore-arm.

In the position shown in Fig. 2, by means of the single rubber attachment, the manipulator acts upon the upper portion of the trunk, neck, head, and arms; by means of the hand-holder, upon the arms; by means of the double-rubber, upon the arms, shoulders, and scalp.



When the acting part or head is lowered to its extreme limit, the machine occupies the least space. In this position, by means of the foot-holder it communicates oscillation to the legs; by means of the single-rubber, it acts upon the feet, ankles, and lower leg; by means of the double-rubber, it acts upon the legs, including the feet, the patient either sitting or lying.

In all of these applications of motion, energy travels from inanimate to animate matter; non-vital contributes to vital energy: and the various processes through which vital power is developed are promoted and carried forward in a degree till the point which constitutes health is attained.



The name, Manipulator, is very naturally applied to the instrument, the action of which resembles so much that of the living operator. It is, however, impossible for the unaided hand to impart the degree of rapidity necessary to secure the effects easily attained by this machine; and, practically, restoration is often secured in cases in which it is quite unattainable by any other remedial agent.



Motion, transmitted by the manipulator, exerts a curative effect in all chronic affections, and is not limited, as is sometimes supposed, to paralytic affections and deformities. In these latter affections it is a great assistance in effecting a cure; while, in chronic affections, whatever the local symptoms, it supplies the additional energy which is indispensable for recovery in all diseases of long standing.



Mode of Operation.—Fig. 4 represents the manipulator in operation. The machine is propelled by steam power at the Invalids' Hotel and Surgical Institute, but may be worked by hand, as here represented. One arm is inserted between the double-rubbing pads, which are raised to about the height of the shoulders, the patient being seated at the side of the machine; the other hand is placed on the lever, and as much pressure is applied as is perfectly agreeable, care being taken to diminish the pressure at any part which is unusually sensitive. All portions of the arm from the shoulder down are successively included in the rubbers, while a suitable degree of reciprocating or rubbing action is obtained by giving motion to the wheel.

To apply the same operation to the other arm, the patient may either turn in his seat or change his position to the opposite side of the machine.

If any portion of the extremity is affected with inflammation or swelling, it is necessary to apply the action described to the whole of the unaffected portion first; after this the affected part may be beneficially operated on, provided that the sensations are strictly heeded, and that it is so managed that only a comfortable feeling is produced.



In Fig. 5, the patient is so seated beside the machine that he can insert one thigh between the pads of the rubber, and also control the lever with the hand. It is sometimes more convenient to suspend a movable weight from the lever. While the machine is running, he can withdraw the leg gradually, as each portion receives its proper amount of action, till the whole, including the foot, becomes glowing with the effect. The boot or shoe affords no impediment to the effect, and should remain on.



Sometimes, especially in the beginning, or when the feet are habitually cold, it is better to apply the action only from the knees down.

The rubbing-pad (d) may be attached to either side of the machine, according to convenience or effect sought. The action derived from the right end of the rock-shaft is much less severe than that from the left, on account of the shape of the rubber appendage, and at the beginning should be used in preference. In Fig. 6, the patient sits on an ordinary stool, or, if feeble, in a chair, and presents any portion of the chest or abdomen to the action of the rubber. The instrument is raised or lowered to suit convenience, while the patient gently presses portions of the trunk successively upon the rubbing-pad. The degree of the effect is thus always under the absolute control of the one receiving the action. This operation, like the preceding, produces great heat, reddens the skin, relieves pain, and greatly stimulates the functions, not only of the skin, but of the organs contained in the cavities of the chest and the abdomen.



The same operation may be applied also to the legs while the patient is standing.

In Fig. 7, the back is presented to the action of the rubbing-pad. The action will, if desired, be made to reach from the neck to the hips, and even to the thighs. All sensitive portions of the back should at first be omitted, in order that they may be benefited by the counter-irritation or drawing away of the blood. This is easily produced by those familiar with the use of the machine. The rubbing of the back should be deferred till the close of each application, in order that the spinal centers may be relieved of hyperaemia, or excess of blood.

The machine, as represented by Fig. 8, is brought to the desired elevation, about as high as the shoulders, and the hand-holder is attached. One arm is extended horizontally, and the hand grasps the hand-holder, while rapid motion is given by turning the wheel. An alternate twisting motion is communicated to the arm, which causes corresponding pressure and relaxation of all the soft tissues of the limb, combined with slight rubbing or attrition. The action is increased by contracting the muscles, and also by grasping at greater distance from the center. Both hands may grasp at the same time, or the two sides may receive the motion in turn. The effect is similar to that of the rubbing before described, but it is less limited; by grasping firmly, it may extend to the whole chest.



The foot-holder is attached, as shown in Fig. 9, and brought by the means before described to a position to receive one foot at a comfortable elevation, the leg being extended, while the patient is seated in an ordinary chair in an easy position. The action is precisely like that above described as applied to the arm, and extends to the thigh and pelvis. If the knee is slightly flexed, the action is almost entirely confined to the lower leg. Each leg may be operated on in turn.

Mode of Applying Mechanical Movements to Very Feeble Invalids.—Experience demonstrates that no degree of feebleness excludes the beneficial use of these operations. Invalids too weak to stand, or able to help themselves in the least degree are often treated with perfect success. A judicious use of the Manipulator always increases nutrition and strength without any fatigue or exhaustion, however feeble the patient may be. It is only necessary to provide for these cases additional conveniences, so that the applications can be made in the recumbent position, and also that proper intervals of rest be allowed between successive operations. For this purpose couches are provided, each containing a certain portion of the Manipulator. These are operated by means of a short connecting-rod, joining the rock-shafts of the two pieces of mechanism, as shown in Fig. 10. The Vibrator has two small discs, or heads acting through an opening in the couch on which the invalid rests. These impinge with a rapid, direct stroke upon the portion of the body exposed to the action. The top of the couch is adjustable, and is quickly placed at the elevation which secures the proper force of the instrument, as shown in Fig 11. By simply turning and moving the body, the patient brings any part in contact with the vibrating discs. The cut represents the Vibrator, in which the force impinges at right angles with the surface of the body, sending waves of motion through its substance.



The rubbing which is shown in Figs. 4 and 5 may be applied to all parts of the body in a recumbent position. A couch is required of similar construction to the vibrating couch, but with a rubbing-pad instead of vibrating heads acting through the opening and operated by appropriate connections, as shown in Fig. 12. The top is adjustable, and the degree of effect desired is capable of easy regulation. The patient turns different portions of the body to the action of the rubber as required.

KNEADING. Kneading is a process applied chiefly to the abdomen. The purpose of this operation is to increase nutrition, the muscular power and action of the abdominal walls, and the function of the organs which they contain. Three modes of applying this operation by the mechanical apparatus are in use, effected by the Direct, the Rotary, and the Revolving Kneader.



THE DIRECT KNEADER. This resembles in form and action the vibrating instrument shown in Fig. 11. The impinging heads, however, are made broader, the motion greater in extent, and the rate of motion less than one-tenth of that employed for the purpose of vibrating. This slowness of motion seems to increase the action of the muscles.

THE ROTARY KNEADER. The action of the kneading heads in this form of apparatus, as shown in Fig. 13, is inward and upward alternately, and it is eminently well calculated to stimulate the action of the abdominal organs.

THE REVOLVING KNEADER. In the form of kneading apparatus, shown in Fig. 14, two thick rollers, which move freely on axes at the extremities of arms, projecting on either side of a shaft turned by a crank or belt, are made to act alternately upon each side of the abdomen.

In the methods of kneading above described, the degree of force acting on the body is governed by an arrangement for elevating or depressing the upholstered top of the couch upon which the patient rests, and through which the action is transmitted to the body.

If this form of apparatus is driven at a rate ten times more rapidly than is desired for kneading, the effect is vibratory, and it is, in fact, used for that purpose.



THE CURE OF SWELLINGS AND TUMORS.

The application of motion through the Manipulator promotes absorption, and thus all kinds of swellings and non-malignant tumors are made to diminish under its use. In these cases the vessels of the affected part are distended with stagnant blood, and a portion of the fluid passes through their walls, distending the surrounding tissues, which become more or less hardened. By the transmission of active motion to the affected parts, the contents of the vessels are urged forward; the outside fluids are thus permitted to return to the general circulation and become subject to the energetic vital action of the general system, local deficiencies of oxidation being increased to the normal degree, causing destruction of morbid matter and giving place for new and wholesome nutritive materials for vital use. In short, normal functional activity is established, both locally and generally. Scrofulous, dropsical, rheumatic, and other local accumulations disappear, and even tumors are dispersed, by the use of the Manipulator, in cases in which the knife would otherwise be required.

COUNTER-IRRITATION AND REVULSION.

Artificial means have always been employed to produce an energetic flow of blood in different parts of the body, thereby relieving morbid distention of the vessels, and consequent irritation and pain in neighboring parts. Cupping, hot applications, mustard, capsicum, blisters, and other irritants, are resorted to, but their effects, while generally very good in acute cases, are too transient to be of material aid in chronic affections. By the use of the Manipulator, we can produce the most thorough revulsive effects, operating upon large surfaces, and causing large masses of muscle to receive an increased amount of blood, thus drawing it away from parts oppressed by too great a supply, constituting engorgement. No injury is done to the parts acted upon; on the contrary, they are strengthened by the application, which can be repeated as often as necessary till relief is permanent. Thus, the head, heart, digestive organs, liver, chest, or whatever part is oppressed by excess of blood, may be speedily and permanently relieved. By means of this ability to relieve any part of the system from engorgement, and consequent inflammation and its results, are we enabled to permanently cure a large variety of chronic inflammatory, ulcerative, and nervous affections.

Local inflammations by this method of treatment may be speedily cured.

CURE OF NEURALGIA.

By the transmission of motion through the Manipulator and other ingeniously devised apparatus and machinery, we increase the functional power and activity of the muscles, and thereby diminish morbid sensibility of the nerves, which is present in neuralgia. Prolonged and excessive nervous action is attended with too great a rush of blood to the nerve-centers, which can only be relieved by increasing the flow in the muscles. Congestion, or hyperaemia, in the spinal cord or brain, or both, is a condition ever present in neuralgia. The application of motion through the manipulator causes the blood to flow to the muscles, thus relieving nervous congestion and consequent neuralgia.

CURE OF PARALYSIS.

In no single disease has the transmission of motion through the Manipulator proved more thoroughly efficacious than in paralysis. The most prominent requirements in these cases seem to be the following:

Excess of blood in the brain and spinal cord needs to be removed and diverted to parts in which it will be useful instead of obstructive.

The contractile power of the capillaries should be improved.

The quality of nutritive fluids should be improved by the promotion of oxidation through increased circulation.

These and many more wants of disordered nerves, are readily supplied by transmitted motion.

The Manipulator combines, in a single ingenious mechanical contrivance, the several movements best adapted for the promotion of healthy functional activity.

CURE OF DEFORMITIES.

"Deformities arising from paralysis and contractions of muscles and tendons, producing stiffened joints and distorted limbs, are of common occurrence. A rational explanation of the wonderful curative results which follow the employment of transmitted motion in these cases may not be without interest to the reader. The muscles are composed of bundles of little fibers which glide upon one another in every movement. Another set of fibers called connective tissue, holds the fibers together in bundles or separate muscles, and interlaces and crosses them in every direction. Now, if these fibers remain long in a fixed position, or are involved in inflammation, there is danger of adhesions forming between them, producing permanent immobility; gliding movements are interfered with, and the muscle ceases to perform its function. Inflammation gives rise to effusion, or the formation of a kind of cement which binds together the muscular fibers and prevents motion.

Rubbing, kneading, and actively manipulating the affected parts with that intensity of administration secured by the manipulator, rends asunder and breaks up these minute adhesions, re-establishing gliding motions, causes absorption of effused materials, and restores the affected part to a normal condition.



The deformed limb is straightened by the filling out of the muscle-cells, and increasing the length and also the nutrition of the affected muscles. No pulling or forced extension is required. Deformity ceases when the conditions upon which it depends are removed by rational appliances, which are always agreeable. No brace, splints, or other confining appliances are necessary, except in rare cases in which the bones are very badly distorted.

In withered and deformed limbs, resulting from infantile paralysis, the manipulator furnishes the most agreeable, direct, and certain remedy. It restores nutrition, sensation, and power, and dispenses almost wholly with mechanical supports. Club-feet, wry neck, spinal curvature, hip-joint disease, white swellings, and stiffened joints, are all readily amendable to the curative effects of motion administered by the manipulator and other machinery.

Contracted and shortened muscles are gradually lengthened by vigorous, long-continued, and frequently repeated rubbing with the manipulator across their longitudinal fibers; bound-down and confined tendons are liberated and normal movements established.

DISEASES OF WOMEN.

Uterine and ovarian congestion, chronic inflammation, discharges, morbid enlargement, prolapsus, anteversion and retroversion, anteflexion and retroflexion, and other derangements of the womb and its appendages, are radically cured by the vibratory, rubbing, kneading, and other movements, administered through the manipulator and other mechanical appliances employed at the Invalids' Hotel and Surgical Institute.

To those who are tired of taking medicine, this mode of treatment commends itself as being both agreeable and efficient. There is no case too weak, nervous, or helpless for the use of this curative agent. It is entirely devoid of objectionable features, being always applied outside the clothing.

CAUSE OF FEMALE WEAKNESS. The true relations of cause and effect are very liable to be misunderstood, when considering the various diseases incident to the organs contained in the female pelvis. Treatment intended to be remedial is therefore very often misdirected and fails to afford relief, positive injury frequently resulting instead. When the nature of these diseases is properly understood, their cure can be effected with comparative ease.

These diseases are always attended with weakness, which is often very great, of the muscles that hold the diseased organs in position. The muscles forming the walls of the abdomen, and the diaphragm, or midriff, all of which are concerned in the act of respiration, become feeble and only partially perform their functions. In health, they act constantly, even during sleep, producing a rhythmical movement, which is communicated to the contents of the abdominal and pelvic cavities. This motion promotes a healthy circulation in the parts. In almost all affections of the pelvic organs, this normal condition is greatly diminished.

Diminution of the motions of respiration is attended with an increase of the amount of the blood in the pelvic organs, constituting an engorgement of the parts, called congestion, or inflammation. This gives rise to enlargement of the womb, ulcerations, tumors, and a multitude of kindred secondary effects, usually considered as the primary disease and treated as such. The contents of the cavity of the trunk, weighing several pounds, are allowed to gravitate down and rest upon the contents of the pelvis, forcing the congested uterus and ovaries down out of their natural positions, and often bending or tipping the womb in various directions. A long list of symptoms follows as the natural consequence of these abnormal conditions.

RATIONAL TREATMENT. Ovarian congestion and inflammation, inflammation of the uterus, ulceration of this organ, deranged menstruation, leucorrhea with the attendant pain, nervousness, and other derangements depending upon loss of supporting power in the abdominal muscles, all result from loss of the natural motions of respiration, and consequent deranged circulation. These several conditions can be cured by removing their cause. When the power of the parts involved in the weakness is restored, all these morbid conditions disappear. Judicious cultivation of power in the weakened supports is attended with certain curative results. This is best accomplished by mechanical motion, by which the normal circulation is restored, inflammations and congestions are subdued, displacements corrected, ulcers healed, and functional activity is re-established.

RECAPITULATION.

Motion properly transmitted to the human system by mechanical apparatus is transformed into other forms of force identical with vital energy, by which the ordinary processes of the system are greatly promoted.

It increases animal heat and nervous and muscular power to the normal standard.

It removes engorgement or local impediments to the circulation.

The electrical induction produced renders it a most efficacious remedy for paralysis of all kinds.

It removes interstitial fluids and causes rapid absorption and disappearance of solid and fluid accumulations.

It is a powerful alterative, or blood-purifier, increasing oxidation and stimulating excretion.

It diminishes chronic nervous irritability and promotes sleep.

Deformities are easily cured without the cutting of tendons, or use of mechanical supports.

It hardens the flesh by increasing muscular development and improves digestion and nutrition.

* * * * *



WORLD'S DISPENSARY MEDICAL ASSOCIATION

INCORPORATED UNDER STATUTE ENACTED BY THE LEGISLATURE OF NEW YORK.



Dr. R.V. PIERCE, having acquired a world-wide reputation in the treatment of Chronic Diseases, resulting in a professional business far exceeding his individual ability to conduct, some years ago induced several medical gentlemen of high professional standing to associate themselves with him, as the Faculty of the World's Dispensary and Surgical Institute, the Consulting Department of which has since been merged into the Invalids' Hotel. The organization is duly incorporated under a statute enacted by the Legislature of the State of New York, and under the name and style of the "WORLD'S DISPENSARY MEDICAL ASSOCIATION," of which Dr. PIERCE is President, and in the affairs of which he will, as heretofore, take an active and constant part.

* * * * *

EUROPEAN BRANCH, NO. 3 NEW OXFORD STREET, LONDON, ENG.

* * * * *

IMPORTANT ANNOUNCEMENT.

Dr. R.V.PIERCE, having in the Fall of 1880 resigned his seat in Congress, has since been able to devote his whole time and attention to the interests of the Association, and those consulting our Medical and Surgical Faculty have the full benefits of his council and professional services. That he should prefer to give up a high and honorable position in the councils of the nation, to serve the sick, is conclusive evidence of his devotion to their interests and of love for his profession.

* * * * *



INVALIDS' HOTEL

A MODEL SANITARIUM AND SURGICAL INSTITUTE.

NOT A HOSPITAL, BUT A PLEASANT REMEDIAL HOME,

ORGANIZED WITH

A FULL STAFF OF EIGHTEEN PHYSICIANS AND SURGEONS

AND EXCLUSIVELY DEVOTED TO THE

TREATMENT OF ALL CHRONIC DISEASES.

This imposing Establishment was designed and erected to accommodate the large number of invalids who visit Buffalo from every State and Territory, as well as from many foreign lands, that they may avail themselves of the professional services of the Staff of Skilled Specialists in Medicine and Surgery that compose the Faculty of this widely-celebrated institution.

DESTROYED BY FIRE.

On the sixteenth of February 1881, the original Invalids' Hotel was totally destroyed by fire. Although occupied at the time by a large number of invalids, yet, through the extraordinary exertions of the Faculty and employees, all were safely removed from the building without injury to any one. The Board of Trustees took prompt steps to rebuild, for the accommodation of the many sufferers who apply, to avail themselves of the skill, facilities and advantages of treatment which such a perfectly equipped establishment affords. Profiting by the experience afforded by several years' occupancy of the original Invalids' Hotel building, which at the date of its erection was the largest and most complete establishment of its kind in the world, we believe we have, in the building of the elegant structure illustrated herein, made great improvements over the original Invalids' Hotel, for the accommodation of our patients. Although our new building has only been occupied about two years, yet almost immediately our business required the erection of a very large addition thereto, to accommodate our growing practice. This large Annex, which is about the size of the original building, has ever since been kept well filled with patients, hailing from every State and Territory of the United States, Canada and occasionally from a foreign country,

THE INVALIDS' HOTEL AND SURGICAL INSTITUTE IS PLEASANTLY SITUATED AT NO. 663 MAIN STREET,

in the city of Buffalo, just above and outside the business and bustle of this Queen City of the Lakes. It is easily reached from the railroad depots by the Exchange and Main Street car lines (see map on last page of this book). It is a substantially built brick building, trimmed with sandstone, well lighted and provided with a patent hydraulic elevator, so that its upper stories are quite as desirable as any, being more quiet than those lower down. It is well provided with fire escapes, and, in fact, nothing has been neglected that can add to the comfort and home-like make-up of this popular national resort for the invalid and afflicted. Great pains and expense have been assumed in providing perfect ventilation for every room and part of the building.



The surroundings of the Hotel are very pleasant, it being located in the finest built part of the city, among the most elegant residences.

STAFF OF PHYSICIANS AND SURGEONS.

Only men who are, by thorough education and experience, especially fitted to fill their respective positions, have been chosen to serve as physicians and surgeons in this institution. After having spent a very large sum of money in erecting and furnishing this national resort for invalids with every requirement and facility for the successful treatment of all classes of chronic diseases, it is the determination of the Board of Directors that the Faculty of Physicians and Surgeons shall be superior in culture, experience and skill.

We have not the space to speak, individually, of the eighteen professional gentlemen composing the Faculty, but will say that among them are those whose long connection with the World's Dispensary and Surgical Institute has given them great experience and rendered them experts in their specialties. Several of them had previously distinguished themselves in both private and hospital practice, had held important chairs as lecturers and teachers in Medical Colleges, and had filled responsible positions in military and civil hospitals; also in some of the most noted Asylums, Dispensaries, and Sanitary Institutions in the land.

With such a staff of Physicians and Surgeons, efficient and trained nurses, and with all the most approved sanitary, medical and surgical appliances which study, experience, invention and the most liberal expenditure of money, can produce and bring together in one institution, the Invalids' Hotel and Surgical Institute affords the afflicted unusual opportunities for relief.

THE GRAND ENTRANCE.

The entrance to the Invalids' Hotel and Surgical Institute is covered by a lofty porch of beautiful design, the roof of which is supported upon heavy iron columns. Above the massive double doors, through which the visitor enters, are large, heavy panels of beautifully wrought stained glass, on which the words "Invalids' Hotel and Surgical Institute" stand out conspicuously.



FIRST FLOOR.

The first floor of the building is reached through a beautifully finished vestibule, by a short flight of broad, easy stairs, and once inside the visitor is struck by the beauty of design as well as by the home-like appearance of the surroundings. The wood-work is mainly of hard woods, oak and cherry predominating. In a large part of the house the floors are of oak, with a cherry border, neatly finished in oil and shellac, and covered with rich rugs and elegant carpets of the very best quality.



On the first floor is the gentlemen's reception-room, which is thronged with patients from early in the morning until late in the afternoon. It is entirely distinct from the large reception-room and parlors for lady patients, and the utmost privacy is secured throughout the whole arrangement of the Institution. On this floor are the suites of offices, parlors, and private consultation-rooms, some fifteen in all; also a well furnished reading-room and circulating library, for the use of the inmates of the Institution. On all sides are beautifully frescoed walls adorned with numerous choice engravings and other pictures. All the rooms throughout the house are furnished in the best of style, and in a manner to afford the utmost comfort and cheerfulness of surroundings for the sick and afflicted who seek this remedial resort. The Turkish and other baths are elegantly fitted up on the first floor, opposite the reading-room.

THE UPPER FLOORS.

Above the first, or main floor, the building is divided into separate rooms and suites of rooms for the accommodation of patients. All are well lighted, have high ceilings, and are cheerful and well ventilated apartments. On the second floor is the large medical library and medical council-room, for the exclusive use of the Faculty, also the museum-room, which contains a large and valuable collection of anatomical and morbid specimens, many of them being obtained from cases treated in this Institution. On this floor are also suites of rooms, occupied by the Bureau of Medical Correspondence, wherein from ten to twelve physicians, each supplied with the improved graphophone, are constantly employed in attending to the vast correspondence received from invalids residing in all parts of the United States and Canada. Every important case receives the careful consideration of a council composed of from three to five of these expert specialists, before being finally passed upon and prescribed for.



ON THE THIRD FLOOR

are the large treatment-rooms, supplied with all the apparatus and appliances for the successful management of every chronic malady incident to humanity. Electrical apparatus of the latest and most approved kinds, some of it driven and operated by steam-power, dry cupping and equalizing-treatment apparatus, "vitalization" apparatus, numerous and most ingenious rubbing and manipulating apparatus and machinery, driven by steam-power, are among the almost innumerable curative agencies that are here brought into use as aids in the cure of human ailments. Our

ELECTRICAL OUTFIT



is the finest to be found in any sanitarium in the United States and, we believe, in the world. There are two forty-cell galvanic batteries with switch boards for controlling the voltage, or force, from the whole power to one-fortieth of this amount, at the will of the physician. Safe-guards in the shape of milli-ampere meters continually indicate to the operator the force of the current. There is a dynamo for charging the storage batteries, which may be used in a patient's room when this method is found more convenient or more comfortable for the invalid. There are two static or Franklin machines. These are used when the milder current is desired, and for spraying, sparking, etc. One of the instruments is of high voltage and furnishes us with the X rays for examining the interior parts of the body. The largest treatment room also contains a powerful ozone generator, operated by a dynamo. This supplies the room with allotropic oxygen and is invaluable in treating diseases of the lungs and air passages. This supplies the patient with vitalized air, equal to the most salubrious atmosphere in any part of the globe.

Beyond this and separated by a court, across which is an iron bridge, are the large dispensing-rooms, stocked with drugs and medical compounds of almost endless variety, and representing every branch of the materia medica. Here all medicines prescribed are most carefully and specially prepared for each individual case. Those to be sent away by mail or express, to patients being treated at a distance, are placed in trays, with full directions for use, and sent to another large room, where they are carefully packed, and shipped thence to their destination.

FOURTH FLOOR.

On the fourth floor are located the surgical operating-rooms and surgical ward. There are also a large number of nice, large, well furnished separate rooms on this floor, used principally for the accommodation of surgical cases. Strong, broad, iron staircases connect all the upper floors with the ground, so that in case of fire, patients need have no fear of being unable to get out safely. In fact, the building has been constructed so as to render the rapid spread of fire through it impossible, all the floors being laid on cement.

A STEAM PASSENGER ELEVATOR

is provided, so that the upper floors are quite as desirable as those lower down. The dining-rooms for gentlemen, as well as those for ladies, are located in the basement, which is reached either by stairways or by the elevator. The kitchen, store-rooms, chill-rooms, pantries, and all culinary arrangements are also in the basement.

FIRE-PROOF VAULTS.

Six large fire-proof vaults are provided in this building in which to preserve, secure from observation, as well as from fire, all records of cases examined and treated by the Faculty.

Throughout all this vast building the visitor is struck with the wonderful order and system with which every detail is carried out.

THE BATH DEPARTMENT.



The Invalids' Hotel and Surgical Institute, as hereinbefore indicated, is provided with Turkish, and other approved baths, with a treatment-room, fitted up with vacuum and movement-treatment apparatus of the most modern and approved style. These and much more ingeniously devised apparatus and appliances are brought into use in a great variety of chronic affections with marvelously successful results. A perfect system of physical training, especially adapted to the wants of the invalid and weak, and most skillfully conducted and applied, is not the least important among the many advantages that the chronic sufferers here find.

THE SURGICAL DEPARTMENT.

In the Surgical Department, every instrument and appliance approved by the modern operator is provided, and many and ingenious are the instruments and devices that the Faculty of this institution have invented and perfected to meet the wants of their numerous cases.

OUR REMEDIES.

In the prescribing of remedies for disease, the Staff resort to the whole broad field of materia medica, allowing themselves to be hampered by no school, ism,pathy, or sect. The medicines employed are all prepared by skilled chemists and pharmacists, and the greatest care is exercised to have them manufactured from the freshest and purest ingredients. Our Faculty probably employ a greater number and variety of extracts from native roots, barks and herbs in their practice than are used in any other invalids' resort in the land. All of the vegetable extracts employed in our practice are prepared in our own Laboratory.

REGULATION OF DIET.

The table is supplied with an abundance of wholesome and nutritious food, especially adapted and prepared to suit the invalid, it being varied to suit each particular case. The Faculty recognize the importance of proper food as one of the greatest factors in the treatment of chronic diseases. While properly regulating and restricting the food of the invalid when necessary, they also recognize the fact that many are benefited by a liberal diet of the most substantial food, as steaks, eggs, oysters, milk, and other very nutritious articles of diet, which are always provided in abundance for those for whom they are suited.



From previous experience somewhere, some people get the impression that they are to be half starved at such an institution as this. If this is the case anywhere it is not so here, as any one who has ever resided at our sanitarium will attest.

TRAINED ATTENDANTS.

A sufficient number of trained and experienced nurses are employed, that those requiring attendance may have the very best of care.

GOOD ORDER.

The institution is conducted in an orderly manner, that the utmost quiet may be secured. The Faculty insist, upon the part of the invalid, while under treatment, on the observance of habits of regularity in eating, sleeping, bathing and exercise. Only by such observance of hygienic laws can they succeed in their course of remedial training, and make the treatment curative.

AMUSEMENTS.

While insisting upon strict observance of rules established for the good of the patient, they do not make their requirements so rigid as to interfere with the comfort and enjoyment of their patients, but, on the contrary, endeavor, in every manner possible, to provide innocent and entertaining amusements for all, recognizing the great importance of pleasant occupation of the mind, as an essential part of the treatment. Hence the introduction of music, amusing games, light reading, and kindred agencies for pleasant entertainment, is not neglected.

UNPARALLELED SUCCESS.



The founder of this institution commenced, many years ago, with little capital, to build up a business in the treatment of chronic diseases and devoted himself diligently to that end. His reputation for skill in his chosen field of practice gradually extended until, to-day, his fame and that of the World's Dispensary and Invalids' Hotel and Surgical Institute, are simply world-wide. As the business increased those eminent for skill have been induced to join the Faculty, until eighteen professional gentlemen, each devoting his attention to a special branch of practice, constitute the Medical and Surgical Staff.



One reason why we excel in the treatment of chronic diseases is the fact that we are supplied with all the modern improvements in the way of instruments, appliances and remedial agents used in the healing art, the expense of which deters the local physician in general practice from procuring, for the treatment of the limited number of cases that come within the circuit of his practice. The treatment of such cases requires special attention and special study to be successful.

A COMMON SENSE VIEW.

It is a well-known fact, that appeals to the judgment of every thinking person, that a physician who devotes his whole time to the study and investigation of a certain class of diseases, must become better qualified to treat them than he who attempts to treat every ill to which flesh is heir, without giving special attention to any particular class of diseases. Men, in all ages of the world, who have made their marks, or who have become famous, have devoted their lives to some special branch of science, art or literature.

LIBERALITY.

We wage no war against any physician, no matter what school of medicine he may represent; but, on the other hand, we invite the co-operation of all regular physicians. We are always ready and willing to impart to them any information or render any assistance that will be of mutual benefit to them and their patients.

OUR PHYSICIANS AND SURGEONS

do not travel to solicit practice, having all the business that they can attend to at our institution, nor do we employ any agents to travel and peddle or otherwise sell our medicines. If any one engaged in such business, represents himself as in any way connected with our institutions, he is a swindler and should be apprehended and prosecuted as such. And any one who will give us such information as will lead to the arrest and conviction of any person so misrepresenting will be liberally rewarded.



While not permitting any member of our professional staff to travel and solicit practice, yet we are always willing to accommodate and send a specialist to visit important or critical cases in consultation, or otherwise, or to perform important surgical operations as explained on page 971 of this book.

Let none deceive you by representing that they have heretofore been connected with our institution and have thereby learned our original and improved methods of treatment. We have a large and competent Staff of Specialists and while we have sometimes found it necessary to make changes, yet we always manage to retain the most expert and skillful, as we cannot afford to part with the services of those who excel.



By adopting similar names to those which have long designated our world-famed institutions, some have endeavored to deceive and mislead invalids who were seeking relief. Others have named so-called "Electric" Trusses, "Liver Pads," and other contrivances after our President, thereby expecting to reap benefits from Dr. Pierce's well-known professional standing. Neither the Doctor nor this Association have any interest in any such articles.

NO BRANCHES.—Remember we have no branches except the one at No. 3 New Oxford Street, London, England.

Those desiring to consult us by letter, should address all communications plainly to

World's Dispensary Medical Association, No. 663 MAIN STREET, BUFFALO, N.Y.

* * * * *



WORLD'S DISPENSARY.

The immense building erected and occupied by the World's Dispensary Medical Association as a Laboratory, wherein are manufactured our Dr. Pierce's Standard Family Medicines, as well as all the various Tinctures, Fluid Extracts and other pharmaceutical preparations used by the Staff of Physicians and Surgeons of the Invalids' Hotel and Surgical Institute in their practice, is not inappropriately called the World's Dispensary, for within its walls is prepared a series of remedies of such exceeding merit that they have acquired world-wide fame, and are sold in vast quantities in nearly every civilized country.



The structure, located at 660 to 670 Washington Street, immediately in the rear of the Invalids' Hotel and Surgical Institute, is of brick, with sandstone trimmings, six stories high, and 100 feet square. Its most striking architectural features exteriorly are massiveness, combined with grace and beauty of outline, and great strength.

THE BASEMENT.

The basement or first story opens on a level with the Washington Street sidewalk, and is occupied by a plant of two large boilers, which supply the steam to run a huge American engine, of 100 horse-power, built by the American Engine Co., Bound Brook, N.J. It drives all the machinery of the establishment, including drug mills, pill machines, packing machinery, a large number of printing presses, folding machines, stitching, trimming, and many other machines, located on the different floors, and used in the manufacture of medicines, books, pamphlets, circulars, posters, and other printed matter. On this floor is located steam bottle-washing machinery, and also the shipping department. Here may be seen huge piles of medicine, boxed, marked, and ready for shipment to all parts of the civilized world. A large steam freight elevator leads from this to the floors above.

MACHINERY.



In addition to the power engine just mentioned is a 25 horse-power upright engine for running the dynamo for electric lighting, with a capacity of three hundred (300) lights. This engine and dynamo were also manufactured for us by the American Engine Company of Bound Brook, N.J. There is a small dynamo with a capacity of one hundred (100) lights used during the day to light safes, vaults, dark closets and hallways. All the offices and rooms of patients are supplied with electric light, as well as illuminating gas. An automatic Worthington pump is also located in the basement. This supplies the elevator and sprinkling system. The sprinklers come into play only in case of fire, when they are self-acting. This pump at its best is capable of forcing nearly two hundred gallons of water a minute. There is no place in which pure water is more desirable than in the manufacture of medicines. Our New York filter could, if such a large quantity were ever required, furnish the Dispensary with one hundred (100) barrels of pure water a day. Just beyond the south wall and buried several feet under ground is a boiler-shaped tank capable of storing ten thousand (10,000) gallons of medicine.

MAIN FLOOR.

The main or second floor of the Dispensary is entered from Main Street, through a hall leading from the Invalids' Hotel and Surgical Institute. On this floor are located business offices, counting-room, the advertising department and mailing rooms. Large, fire-proof vaults are provided for the safe keeping of books, papers, and valuables, whilst the counting-room and offices are elegantly finished in hard woods, and present a beautiful and grand appearance.

THIRD FLOOR.

On this floor are the Association's extensive printing and binding works. Fourteen large presses, driven by power, with numerous folding machines, trimming, cutting, and stitching machinery, are constantly running in this department. Here is printed and bound Dr. Pierce's popular work of over a thousand pages, denominated "The People's Common Sense Medical Adviser," over 1,200,000 copies of which have been sold. Millions of pocket memorandum books, pamphlets, circulars and cards are also issued from this department and scattered broadcast to every quarter of the globe.

FOURTH FLOOR.

Large mills for crushing, grinding and pulverizing roots, barks, herbs, and other drugs occupy a considerable part of this floor. Extensive drying-rooms, in which articles to be ground in the drug mills are properly dried, are also located upon this floor, as are also thousands of reams of paper ready for printing the different books, pamphlets, labels, etc. In large rooms set aside for that purpose, are stored vast quantities of labels and wrappers, for use in putting up medicines.

FIFTH FLOOR.

On this floor is located ingeniously devised filling and bottling machinery, also rooms for labeling, wrapping, and packing medicines; others are occupied for the storage of crude drugs, glass, corks, and supplies for use in the general business.

SIXTH FLOOR.

This entire floor is occupied with mixing, percolating, distilling, filtering, and other processes employed in the manufacturing of medicines. Every process is conducted under the watchful care of an experienced chemist and pharmacist, and in the most perfect and orderly manner; the apparatus employed being of the most approved character. Here are manufactured all the various medicinal preparations and compounds prescribed by the Faculty, in the treatment of special cases.

GENERAL CONSIDERATIONS.



In all departments of this vast business establishment, the visitor is struck with the perfect system which everywhere prevails, and the wonderful accuracy with which every process and transaction is carried on and consummated; hence the uniformity of purity and strength for which the medicines here manufactured have so long been celebrated. To this, also, is due much of the marvelous success attained in the department established for the special treatment of chronic and obstinate cases of disease. In this department the Faculty are not at all limited or hampered in prescribing, and do not confine themselves in the least to the proprietary or standard medicines manufactured for general sale through druggists, but employ a series of curative agents unsurpassed in variety and range of application. They aim to carefully adapt their prescriptions to each individual case.

* * * * *



THE

INVALIDS' HOTEL AND SURGICAL INSTITUTE

SOME OF THE CAUSES THAT LED TO ITS ERECTION, AND THE ADVANTAGES WHICH IT AFFORDS.



The destinies of institutions, like those of men, are often determined by pre-existing causes. The destinies of some men are like those of way-side plants, springing up without other apparent cause than the caprice of nature, developing without any apparent aim, yielding no perfected fruit, and finally, dying, leaving scarcely a trace of their existence. Thus it is with institutions which have their origin only in man's caprice. To be enduring, they must be founded upon the needs and necessities of humanity. Many of the great men of the world owe their greatness more to surrounding circumstances than to the genius within them. The highest genius can be dwarfed or deformed by the force of adverse circumstances; hence the poetic truth of Gray in those exquisite lines:

"Some mute inglorious Milton here may lie, Some Cromwell guiltless of his country's blood."

Opportunity is the guiding star of genius. Without it, genius would drift hither and thither upon the restless, ever-changing waves of circumstance, never casting anchor in a secure haven. Upon opportunity, too, depends the success of institutions. By opportunity we mean a real and acknowledged public want. Whoever undertakes to supply this want finds himself upon the crest-wave of prosperity. It was to supply such a want that this institution was erected.

A REMEDIAL HOME.

Of the seventy millions of people living in the United States to-day, it is estimated that nearly twelve millions are sufferers from chronic disease. Think for a moment! Twelve millions of people slowly but surely dying by the insidious and fatal development of chronic diseases! This is an appalling fact. And yet this is the very class of diseases with which the general practitioner is least familiar.

As a general practitioner of the healing art, fresh from curriculum, the founder of this institution early realized that the grand unpardonable sin of the medical profession was the neglect to more thoroughly study and investigate this class of diseases.

The profession is diligently cauterizing and poulticing the sores which now and then appear on the surface, but the internal chronic disease, of which these are merely the external signs, is too often overlooked or neglected.

Some years ago we devised and put into practical operation a method of

TREATING PATIENTS AT THEIR HOMES,

without requiring them to undergo personal examinations. We reasoned that the physician has abundant opportunity to accurately determine the nature of most chronic diseases without ever seeing the patient. In substantiating that proposition, we cited the perfect accuracy with which scientists are enabled to deduce the most minute particulars in their several departments, which appears almost miraculous, if we view the subject in the light of the early ages. Take, for example, the electro-magnetic telegraph, the greatest invention of the age. Is it not a marvelous degree of accuracy which enables an operator to exactly locate a fracture in a sub-marine cable nearly three thousand miles long? Our venerable "clerk of the weather" has become so thoroughly familiar with the most wayward elements of nature that he can accurately predict their movements. He can sit in Washington and foretell what the weather will be in Florida or New York, as well as if hundreds of miles did not intervene between him and the places named. And so in all departments of modern science, what is required is the knowledge of certain signs. From these, scientists deduce accurate conclusions regardless of distance. A few fossils sent to the expert geologist enables him to accurately determine the rock-formation from which they were taken. He can describe it to you as perfectly as if a cleft of it were lying on his table. So also the chemist can determine the constitution of the sun as accurately as if that luminary were not ninety-five million miles from his laboratory. The sun sends certain signs over the "infinitude of space," which the chemist classifies by passing them through the spectroscope. Only the presence of certain substances could produce these solar signs.



So, also, in medical science,

DISEASE HAS CERTAIN UNMISTAKABLE SIGNS,

or symptoms, and, by reason of this fact, we have been enabled to originate and perfect a system of determining with the greatest accuracy the nature of chronic diseases without seeing and personally examining our patients. In recognizing diseases without a personal examination of the patient, we claim to possess no miraculous powers. We obtain our knowledge of the patient's disease by the practical application of well-established principles of modern science to the practice of medicine. And it is to the accuracy with which this system has endowed us that we owe our almost world-wide reputation for the skillful treatment of all lingering, or chronic, affections. This system of practice, with the marvelous success which has been attained through it, demonstrates the fact that diseases display certain phenomena, which, being subjected to scientific analysis, furnish abundant and unmistakable data to guide the judgment of the skillful practitioner aright in determining the nature of diseased conditions.

So successful has been this method of treating patients at a distance that there is scarcely a city or a village in the United States that is not represented by one or more cases upon the "Records of Practice" at the Invalids' Hotel and Surgical Institute. In all chronic diseases that are curable by medical treatment, it is only in very rare cases that we cannot do as well for the patient while he or she remains at home, as if here in person to be examined. But we annually treat hundreds of cases requiring surgical operations and careful after-treatment, and in these cases our Invalids' Hotel, or home, is indispensable. Here the patient has the services not only of the most skillful surgeons, but also, what is quite as necessary in the after treatment, of thoroughly trained and skilled nurses.

What should be the essential characteristics of an Invalids' Home?

CLIMATE.

Obviously, the most important of these characteristics is climate. Climatology, from being a mere speculative theory, has arisen to the deserved rank of a science. The influence of the climate of a country on the national character has long been observed and acknowledged. The languid but passionate temperaments of the South are like its volcanoes, now quiet and silent, anon bursting forth with terrible activity, flooding entire cities with molten fire; or, like its skies, now sunny, cloudless, an hour hence convulsed with lightnings and deluging the earth with passionate rain; or like its winds, to-day soft, balmy, with healing on their wings, to-night the wind fiend, the destroying simoom, rushing through the land, withering and scorching every flower and blade of herbage on its way. On the other hand, the calm, phlegmatic temperament of the North accords well with her silent mountains, her serener skies, and her less vehement, but chilling winds. The South, too, is the native home of the most violent acute diseases, such as yellow fever and cholera. But, aside from this general climatic influence, there is the yet more restricted one of locality. It has often been observed that certain classes of diseases are most prevalent in certain localities, the prevalence in every instance being due to peculiarities of climate.

EXTREME HEALTHFULNESS OF BUFFALO.

In the published records of the examination for military service in the army, during our late civil war, this fact was clearly and definitely stated, and maps were prepared and presented showing the comparative prevalence of certain diseases in the several States and districts represented. The maps are prepared by a graduation of color, the lighter shades indicating the localities where the special disease under consideration is least prevalent; and it is a very significant and important fact that in all chronic diseases not due to occupation or accident, Buffalo and its immediate vicinity is marked by the lighter shades. Thus, in epilepsy, paralysis, scrofula, rheumatism, and consumption, our city is little more than tinted with the several colors used to denote these diseases.



There is a popular, but unfounded, belief that Buffalo is a hot-bed for pulmonary diseases. This idea could have originated only in an ignorant disregard of facts; for medical statistics prove that in her freedom from this class of diseases she is unrivaled by any city in America, not excepting those on the seaboard.

EVIDENCE OF HEALTH STATISTICS.

Compare, if you please, the statistics of Buffalo with those of the great Eastern cities in this respect. In Boston and New York the death-rate from consumption shows a ratio of about 1 to 5 of the whole number of deaths. In Baltimore and Philadelphia the ratio is 1 to 6, while in Buffalo the death rate from consumption is only 1 to 10—very remarkable difference in favor of our city. Only last summer a gentleman residing in the eastern part of our State collected and compared the health statistics for 1876 of all the prominent cities in the United States. The result showed that

BUFFALO OUTRANKS ALL IN HEALTHFULNESS.

A great deal of precious breath has been expended in blustering about "Buffalo zephyrs," as our delightful lake breezes are sometimes ironically termed. It seems to be a popular belief among our sister cities that old Boreas has chosen Buffalo for his headquarters. When we hear a person dilating upon "Buffalo's terrific winds," we are reminded of one of our lady acquaintances who recently returned from a European tour. She was asked how she enjoyed her sea voyage, and she replied, "Oh, it was delightful, really charming! There is something so grand about the sea!" We were not a little surprised at this enthusiastic outburst, as we had been told by a member of her party that the lady had industriously vomited her way to Hamburg and back again. But the lady's enthusiasm was easily explained. It is fashionable to characterize sea voyages as delightful, charming, etc. Now, we suspect this popular notion about our "trying winds" is traceable to the same source. It has become customary to call Buffalo a "windy place," and so, when the traveler feels a slight lake breeze, he imagines it to be a terrific gale. Whatever may have originated this notion, certain it is that it is utterly, undeniably false; and, in making this denial, we are not alone dependent upon observation, but upon the

FACTS OF SCIENCE.

The issue of July 18, 1874, of the Buffalo Commercial Advertiser, contained a series of tables, furnished by the Signal Service Bureau, showing the velocity of the wind at eleven prominent cities for the year 1873. An examination of the table shows that the total velocity for the year was the lowest in Buffalo of any of the lake ports; while Philadelphia and New York showed far higher aggregates of velocity than our city. On this subject, in the issue of August 21st of the same year, the editor pleasantly remarks: "Only the interior and southern seaboard cities, and not many of them, show a lower total velocity of wind than is marked against this city; and as for those places, heaven help their unfortunate inhabitants in the sultry nights of the summer season, when they are gasping in vain for a breath of that pure, cool lake air, which brings refreshing slumbers to the people of blessed, breezy Buffalo."

EQUABILITY OF CLIMATE.



Then, in regard to equability of climate, the great desideratum for invalids in any locality, here again sentiment and science are greatly at variance. An examination of the official records of the Signal Service Bureau, and the statistics of the Smithsonian Institute, showed that out of a list of forty cities on the continent Buffalo ranked highest for equability of climate. Thus we quote from an editorial in the Advertiser of the same issue: "While the aggregate of change for Buffalo stood at 67 for the year, that of Philadelphia reached 204, Washington was 224, Cincinnati 205, St. Louis 171. Winchester, in one of the healthiest parts of Virginia, reached as high as 201. Aiken, in South Carolina, a famous resort for invalids, touched 220. St. Augustine, one of the lowest in the list, showed a much less equable climate than that of Buffalo, being 94 to our 67." The transition from summer to winter, and vice versa, is exceedingly gradual, and, consequently, Buffalonians are seldom afflicted with those epidemic diseases which generally appear in other localities during the spring and summer months. Thus the thermometric readings of the Signal Service Bureau for 1873, show that the average temperature for July and August was 74 deg.. For September it was about 64 deg., which was again reduced by about 10 deg. for October. The monthly average for November was 73 deg., and for December 25 deg., which was also the average for January. Then the readings for February showed an average of 26 deg., for March 32 deg., and 43 deg. for April. A more equable and gradual transition from midsummer heat to midwinter cold cannot be shown by any locality on this continent. Seldom does the mercury rise above ninety during our warmest summers, or fall below zero in our most severe winters. In J. Disturnal's work, entitled "The Influence of Climate in North and South America," published by Van Nostrand, in 1867, the climate of Buffalo is thus characterized: "From certain natural causes, no doubt produced by the waters of Lake Erie, the winters are less severe, the summers less hot, the temperature night and day more equable, and the transition from heat to cold less rapid, in Buffalo than in any other locality within the temperate zone of the United States, as will be seen by the following table." The table referred to shows that, "during the summer months, the temperature of Buffalo is from 10 deg. to 20 deg. cooler than that of any other point east, south, or west of the ports on Lake Erie; while the refreshing and invigorating lake breeze is felt night and day." The author further adds that "during the winter months the thermometer rarely indicates zero, and the mean temperature for January, 1858, was 20 deg. above."

A careful investigation into the comparative climatology of the several great social and commercial centers, proved Buffalo to be superior to all others in the climatic requirements for the invalid. Besides, it has the important advantage of being a central point of traffic and travel between the West and the East.

ADVANTAGES OF LOCATION.

The second important consideration in projecting this home for invalids was location. It has generally been customary to locate institutions of this character in rural districts, removed from the advantages of city life, on the plea of escaping the confusion and excitement so detrimental to recovery. The result is well known. Invalids have regarded them more as pleasure resorts than health resorts, spending the summer months there, but fleeing to their homes at the fall of the first snow-flake. The good that was done in the summer is undone by carelessness and exposure in the winter. A location that would combine both city advantages and rural pleasures, seemed to us, upon reflection, to be the desirable one. Fortunately, Buffalo afforded the happy mean. Our extensive parks, our unsurpassed facilities for yachting, fishing, and all aquatic sports, our many sylvan lake and river retreats, our world-famed Niagara,—certainly a more desirable selection of rural scenes and pleasures cannot be found in another locality in America.

A GENUINE HOME.

In erecting the Invalids' Hotel and Surgical Institute, our paramount design was to make it a genuine home—not a hospital—a home where the child of fortune would miss none of the comforts of her palatial home, while the poor man would find not only health but his pleasures multiplied a thousand fold.

OUR TERMS MODERATE.

The wholesale merchant's prices are far less than those of the retail dealer. He can afford it, his sales are so much larger. It is on precisely the same principle that we are able to make the rates at the Invalids' Hotel and Surgical Institute comparatively low. If we had only a limited number of patients, we should be obliged to make the charges commensurate with our expenses; but our practice having become very extensive, and the income being correspondingly large, we are enabled to make the rates at the Invalids' Hotel and Surgical Institute so moderate that all who desire can avail themselves of its medical, surgical, and hygienic advantages.



FACILITIES FOR TREATMENT.

Of the many advantages afforded by the Invalids' Hotel and Surgical Institute, in treating disease, we can make only brief mention of a few of the more prominent.

DIVISION OF LABOR.

In the examination and treatment of patients, our practice is divided into specialties. Each member of the Faculty, although educated to practice in all departments of medicine and surgery, is here assigned to a special department only, to which he devotes his entire time, study and attention.

ADVANTAGES OF SPECIALTIES.

The division-of-labor system proves as effectual in the exercise of the professions as in manufactures. In the legal profession this has long been a recognized fact. One lawyer devotes his attention specially to criminal law, and distinguishes himself in that department. Another develops a special faculty for unraveling knotty questions in matters of real estate, and, if a title is to be proved, or a deed annulled, he is the preferred counselor. In a certain manner, too, this has long been practiced by the medical profession. Thus some physicians (and we may add physicians who call themselves "regular," and are specially caustic in their denunciation of "advertising doctors") are accustomed to distribute cards among their patrons, certifying that they give special attention to diseases of women and children. In this institution each physician and surgeon is assigned a special department of medicine or surgery. By constant study and attention to his department, each has become a skillful specialist, readily detecting every phase and complication of the diseases referred to him. Not only is superior skill thus attained, but also rapidity and accuracy in diagnosis.

Thoroughness and efficiency in any branch of learning can be secured only by devoting to it special study and attention. When the faculty of a university is to be chosen, how are its members selected? For instance, how is the chair of astronomy filled? Do they choose the man who is celebrated for his general scholastic attainments, or do they not rather confer it upon one who is known to have devoted special attention and study to the science of astronomy, and is, therefore, especially qualified to explain its theories and principles? Thus all the several chairs are filled by gentlemen whose general scholarship not only is known to be of the highest standard, but who devote special attention to the departments assigned them, thus becoming proficient specialists therein. The same system of specialties is observed in the departments of a medical college. The professor who would assume to lecture in all the departments with equal ease and proficiency would be severely ridiculed by his colleagues; and yet it is just as absurd to suppose that the general practitioner can keep himself informed of the many new methods of treatment that are being constantly devised and adopted in the several departments of medicine and surgery.

PROGRESS IN MEDICINE.

In no other science is more rapid and real progress being made at the present time than in that of medicine. Even the specialist must be studious and earnest in his work to keep himself well and accurately informed of the progress made in his department. Thus it so often happens that the general practitioner pursues old methods of treatment which science has long since replaced with others, acknowledged to be superior. The specialist, on the contrary, by confining his studies and researches to one class of diseases only, is enabled to inform himself thoroughly and accurately on all the improvements made in the methods and means of practice in his special department.

The difference between the practice of specialists and that of general practitioners is aptly illustrated by the difference between the old-fashioned district school, in which the school-master taught all the branches, from a-b-abs to the solution of unknown quantities and the charmed mysteries of philosophy, and the modern seminary, with its efficient corps of teachers, each devoting his or her whole attention to the study and teaching of one special department of learning.

We attribute the success which has attended the practice at the Invalids' Hotel and Surgical Institute, in a great measure, to a wise adoption of this system of specialties.

ADVANTAGES OFFERED TO INVALIDS.

Obviously, the most important of these advantages is facility of treatment. Of the thousands whom we have cured of chronic diseases, we have probably not seen one in five hundred, having accomplished the desired result through remedies sent either by mail or express, and advice given by letter. Yet in some obstinate forms of disease, we can here bring to bear remedial means not to be found or applied elsewhere.

That thousands of cases of chronic disease, pronounced incurable, have, by our rational and scientific treatment, been restored to perfect health, is conclusively proved by the records of practice at the Invalids' Hotel and Surgical Institute. Here, in obstinate cases, are brought to bear all the most scientific remedial appliances and methods of treatment.

A system of mechanical movements, passive exercises, manipulations, kneadings and rubbings, administered by a large variety of ingeniously-contrived machinery, driven by stream-power, has been found especially efficacious and valuable, as an aid to medical and surgical treatment, in the cure of obstinate cases of nervous and sick headache, constipation, paralysis, or palsy, stiffened joints, crooked and withered limbs, spinal curvature, tumors, diseases of women, especially displacements of the uterus, or womb, such as prolapsus, retroversion and anteversion, chronic inflammation, enlargement and ulceration of the uterus, and kindred affections; also in nervous debility, sleeplessness, and other chronic diseases. Mechanical power, or force, is by these machines transmitted to the system, in which it is transformed into vital energy and physical power or strength. This mechanical, passive exercise, or movement-cure treatment, differs widely from, and should not be confounded with, "Swedish movements," to which it is far superior in efficacy. Coupled with our improved and wonderful system of "Vitalization" treatment, it affords the most perfect system of physical training and development ever devised. For the restoration of power to wasted, undeveloped, or weakened organs or parts, for their enlargement, this combined movement and "Vitalization" treatment is unequaled. It can be applied to strengthen or enlarge any organ or part. We also employ both Dynamic and Static electricity, "Franklinism" and Electrolysis, and chemical, Turkish and other baths, in all cases in which they are indicated. Inhalations, administered by means of the most approved apparatus, are employed with advantage in many obstinate lung, bronchial, and throat affections. We have no hobby or one-idea system of treatment, no good remedial means being overlooked or neglected.