THE PEOPLE’S 
COMMON SENSE 
MEDICAL ADVISER 
IN' PLAIN ENGLISH, 
OR 
MEDICINE SIMPLIFIED. 
BY 
fl. "v_ pierce, ive. id., 
Counselor- in- Chief of the Board of Physicians and Surgeons, 
at the World's Dispensary. 
BUFFALO, N. Y. 
published at the world’s dispensary-printing office and bindery. 
1875. Entered according to Act of Congress, in the year 1874, 
By R. Y. PIERCE, 
In thef office of the Librarian of Congress at Washington, I>. C. 
Chas. J. Onink, 
STEKEOTYPER, 
216 Washington St. TO 
MY PATIENTS, 
WIIO HAVE SOLICITED MY PROFESSIONAL SERVICES, 
FROM THEIR HOMES 
IN EVERY STATE, CITY, TOWN AND ALMOST EVERY HAMLET 
WITHIN THE AMERICAN UNION; 
AND ALSO TO THOSE DWELLING IN EUROPE, MEXICO, SOUTH 
AMERICA, THE EAST AND WEST INDIES, AND OTHER 
FOREIGN LANDS, 
I RESPECTFULLY DEDICATE 
THIS WORK. PREFACE. 
Every family needs a Common Sense Medical Advisee. The 
frequent inquiries from his numerous patients throughout the 
land, suggested to the Author the importance and popular de- 
mand for a reliable work of this kind. Consequently, he is 
induced to prepare and publish an extended dissertation upon 
Physiology, Hygiene, Temperaments, Diseases and Domestic 
Remedies. It is for the interest and welfare of every person to 
understand not only the means for preserving health, but also 
those remedies necessary to be employed for the alleviation of 
the common ills of life. 
Accidents of all kinds—injuries sustained by Machinery, Con- 
/ 
tusions, Drowning, Poisoning, Fainting, etc., likewise sudden 
attacks of painful diseases, such as Headache, Heart and Nervous 
Ailments, inflammation of the Eye, Ear and other Organs—require 
a knowledge on the part of the unprofessional, in order that 
proper means may be employed for speedy relief. To impart 
this necessary information is the aim of the Author. 
Moreover, this volume treats of Human Tempei'aments, not 
only of their influence upon mental characteristics and bodily 
susceptibilities, but also of their vital and non-vital combinations, 
which communicate to the offspring either health, hardihood and 
longevity, or feebleness, disease and death. It clearly points out 
those temperaments which are compatible with each other and 
harmoniously blend, and also those which, when united in mar- 
riage, result in Barrenness, Scrofula, Deformity and Idiocy. 
These matters are freely discussed from original investigations 
and clinical observations, thus rendering the work a true and 
scientific guide to marriage. VI 
PREFACE. 
While instruction is imparted for the care of the body, those 
diseases—far too prevalent—are investigated which are sure to 
follow, as a consequence of certain abuses, usually committed 
through ignorance. That these ills do exist is evident from the 
fact that the Author is consulted by multitudes of unfortunate 
young men and women, who are desirous of procuring relief 
from the weaknesses and derangements incurred by having 
unwittingly violated physiological conditions. 
Although some of these subjects might seem out of place 
in a work of this character, designed for every member of the 
family, yet they are treated in a style which cannot offend 
the most fastidious, and with a studied avoidance of all language 
that can possibly displease the chaste, or disturb the delicate 
susceptibilities of persons of either sex. 
This book is not designed to be excluded from the young, for 
it is eminently adapted to their wants, and imparts information 
without which millions will suffer untold misery. It is a false 
modesty that debars the youth of our land from obtaining such 
information. 
As the title of the book indicates, the Author aims to make it 
a useful and practical Medical Adviser. He proposes to express 
himself in plain and simple language, and as far as possible to 
avoid the use of technical words, so that all may readily compre- 
hend and profit by a perusal of this work. Written as it is amid 
the many cares attendant upon a practice embracing the treat- 
ment of thousands of cases annually, and therefore containing the 
fruits of a rich and varied experience, some excuse exists for any 
literary imperfections which the critical reader may observe. 
Buffalo, January, 1875. 
TIIE AUTHOR. INTRODUCTORY WORDS. 
1. Health and disease are physical conditions upon which 
pleasure and pain, success and failure depend. Every individual 
gain increases public gain. Upon the health of the people is 
based the prosperity of nations; by it every value is increased, 
every joy enhanced. Life is incomplete without the use of 
healthy organs and faculties, foi* these give rise to the delightful 
sensations of existence. Health is essential to the accomplish- 
ment of every purpose. Sicknesl thwarts the best intentions and 
loftiest aims. We are continually deciding upon those conditions 
which either tide us with joy and happiness or occasion pain and 
disease. Prudence requires us to meet the foes and obviate the 
dangers which threaten us, by turning all of our philosophy, 
science and art into practical common sense. 
2. The profession of medicine is no sinecure; its labors are 
constant, its toils unremitting, its cares unceasing. The physi- 
cian is expected to meet the grim monster, “ break the jaws of 
death and pluck the spoil out of his teeth.” His ear is ever 
attentive to entreaty, and within his faithful breast are concealed 
the disclosures of the suffering. Success may incite him with 
conceit, as conquest flushes the victor. We lavish honors upon 
army chiefs who have slain their hundreds; disease slays its tens 
of thousands, and is not the defeat of this foe a more brilliant 
achievement ? Is it meritorious in the physician to modestly 
veil his discoveries regardless of their importance ? If he have 
light, why hide it from the world? Truth should be made as 
universal and health-giving as sunlight. We say, give light to all 
who are in darkness, and a remedy to the afflicted everywhere. 
3. We, as a people, are becoming idle, living in luxury, ease 
and in the gratification of artificial wants. Some indulge in the 
use of food rendered unwholesome by bad cookery, and think 
more of gratifying a morbid appetite than of supplying the body 
with proper nourishment. Others devote unnecessary attention viii 
INTRODUCTORY WORDS. 
to the display of dress and a genteel figure, yielding themselves 
completely to the sway of fashion. People manifest shoddy in 
their cookery, dress and appearance as much as they expose their 
bad habits by a tobacco-tainted breath, beer-bloated body, or 
rum-emblazoned nose. They coddle themselves instead of prac- 
ticing self-denial, and appear to think that the chief end of life 
is gratification, rather than useful endeavor. We purpose to 
express ourselves candidly and earnestly upon all topics relating 
to health, and appeal to the common sense of the reader for 
justification. 
4. Although it is our aim to simplify the work, and render 
it a practical common sense guide to the farmer, mechanic, mar- 
iner and day laborer, yet we trust that it may not prove less 
acceptable to the scholar, in its discussion of the problems of 
Affinity, Life and Mind. Not only does our method of treating 
of the Functions of the Brain and Nervous System present many 
new suggestions, in its application to health-culture, management 
of disease, human temperaments, marriage, generation, and to the 
development and improvement of man, but our conclusions cor- 
respond to the results of the latest investigations of the world’s 
most distinguished savants. Our object is to inculcate the facts 
of science rather than the theories of philosophy. 
5. Unto us are committed important health trusts which we 
hold, not merely in our own behalf, but for the benefit of others. 
If we discharge the obligations of our trusteeship, we shall 
enjoy present strength, usefulness and length of days; but if we 
fail in their performance, then inefficiency, incapacity and sick- 
ness will follow, whose sequel is pain and death. Let us then 
prove worthy of this generous commission, that we may enjoy 
the sweetest of all pleasures, the delicious fruitage of honest toil 
and faithful obedience.  i. 
PHYSIOLOGY. 
CHAPTER I. 
BIOLOGY. 
7. In this chapter we propose to consider Life in its earliest 
manifestations. There is little difference between the mean- 
ings of Biology and Physiology. Biology is the science of Living 
Bodies, or the science of Life. Each organ of a living body 
has a function to perform, and Physiology treats of these 
functions. 
8. Function means a living process. There can be no vital 
action without change, and no change without organs. Every 
living thing has a structure, and Anatomy treats of the struc- 
tures of organized bodies. Several chapters of this work are 
devoted to Physiological Anatomy, which treats of both the 
organization and functions of Man. 
9. The initiation of Life is called Generation ; its continuance, 
Reproduction. By the former function, individual life is in- 
sured; by the latter, it is maintained. Since nutrition sustains 
life, it has been pertinently termed, perpetual reproduction. 
10. latent Iiife, as a primordial element, lies concealed 
in a small globule — a mere atom of matter—in the sperm cell. 
This element is something which, under certain conditions, will 
develop functions. The entire realm of nature teems with these 
interesting phenomena, and discloses that continual adjustment of 
9 10 
COMMON SENSE MEDICAL ADVISEE. 
internal to external relations, which claims our profound atten- 
tion. We are simply the humble acolytes waiting in the vesti- 
bule of nature’s glorious sanctuary, to receive from savants the 
interpretation of her divine mysteries. 
11. Some have conjectured that chemical and physical forces 
include all the phenomena of life, and that organization is not 
the resultant of Vital Forces. Physical science cannot inform us 
what must have been the beginning, or how the vital, is the result 
of chemical forces, nor yet can it tell us what transmutation it 
will undergo at the end of organized existence. Although this 
mysterious life-principle eludes the grasp of the philosopher, 
yet it seems as if left in the world to be for all time, the 
astonishing miracle and indubitable testimony of a Divine Power. 
12. The physical act of Generation is accomplished by the 
union of two cells; and this conjugation is known to be so gen- 
erally indispensable to all living things, we may fairly infer 
that it is a universal necessity. Investigations with the micro- 
scope have destroyed the hypothesis of “ spontaneous generation.” 
These show us that even the minutest forms of life are dependent 
upon a parent organization. 
13. Iiife iai a latent condition.—The vital principle 
is dormant in the sperm cell, and so long as it remains there, can 
have no destiny. That part of the cell which organically repre- 
sents this life, is called the Spermatozoon, which consists of a 
flattened body, with a long appendage tapering to the finest 
point. If we remember that a line is the one-twelfth part of an 
inch in length, we may form some idea of the exceeding minute- 
ness of the body of a human Spermatozoon, when we state that 
it is from the to the of a line, and the filiform tail, 
-gL- of a line in length. This life-atom which can be dis- 
cerned only with a high magnifying power, is perfectly trans- 
parent and moves about by executing a vibratile motion with its 
long appendage. Within this speck of matter—almost inconceiv- 
ably small—is hidden all the multifarious forces which result in 
organization. Magnify this infinitesimal nothing a thousand 
times and no congeries of formative powers are perceived where- 
with to work out the wonders of its existence. Yet it contains 
the principle, which is the contribution on the part of the male, 
towards the generation of a new being. LIFE IN A LATENT CONDITION. 
14. The human ovum, or germ cell, is the special contribution 
on the part of the female for the production of another being. 
This cell, though somewhat larger than the Spermatozoon, is also 
extremely small, measuring not more than to of a line in 
diameter, or from to of an inch. 
FIG. 4. 
A. Human Spermatozoon magnified 2,400 times. 
B. Spermatozoa of Man viewed on the surface and edgewise. 
C. D, E and F. Development of Spermatozoa within the Vesicles of Evolution. 
G. Cell of the sponge resembling a Spermatozoon. 
H. Vesicles of Evolution from the seminal fluid of the Dog in the parent cell. 
I. Single Vesicles of different sizes. 
J. Human Spermatozoon forming in its cell. 
K. liupture of the cell and escape of the Spermatozoon. 
15. It appears that the sperm and germ cells contain the 
ultimate elements of all organic structures, and both possess 
the special qualities and conditions by which they may evolve 
organic beings. Every cell is composed of minute grains and 12 
COMMON SENSE MEDICAL ADVISER. 
within these particles vital action takes place. The inte- 
rior of a cell consists of forming, growing matter; the exterior, 
of formed matter which is not as active. When the life-princi- 
ple is communicated to it, the cell possesses inherent powers of 
changing itself. While vital conversion takes place within 
the cell, deteriorating changes occur in the constructed parts. 
Although vital operations build up, yet animal and nervous 
functions are continually disintegrating (wasting) these struc- 
tures. 
16. Throughout the animal kingdom, germ cells possess the 
same material aspects when carefully examined with the best 
microscopical instruments. No difference can be observed in 
the cells of the flowers of the oak and the apple, but the cells of 
the one always produce oak trees, whilst those of the other 
always produce apple trees. The same is true of the germs of 
animals, for there is not the slightest appreciable difference. 
We are unable to perceive why one cell should give rise to a 
spider, while another exactly like it gives rise to a bird; for 
aught we know, the ultimate atoms of the cells of matter are 
identical in physical character, at least we have no means of 
detecting any difference. What then prompts to such dissimilar 
developments ? 
17. We abstract from the facts of development a type, 
representing a power according to which, organization follows 
with regularity. Although germ cells are identical in form, 
yet they manifest various powers. The spermatic particle of a 
duck, by micrometrical measurement as to length, breadth and 
thickness, or external appearance, cannot be distinguished in 
any way from another of a reptile. These two particles possess 
different type powers, which unfold those qualities and condi- 
tions that distinguish the duck from the reptile. The formative 
principle is distinct in each, although the physical aspects are 
the same. This indicates that life in its latent condition is what 
it represents in after organization; that it contains, within 
itself, what it afterward evolves to the world without. For 
development implies that there is in the thing to be developed, 
power to unfold and expand. It manifests individuality—result- 
ant organization—and portrays expression, more vividly than art 
by the help of sunlight reflects an image. THE PROCESS OP GEX-EEATIOIST. 
THE PROCESS OF GENERATION. 
18. This living principle, represented in a sperm cell by a 
Spermatozoon, must be imparted to a germ cell, and the manner 
of its accomplishment indicates its spiritual constitution. It is 
done instantaneously by the momentary contact of a sperm and 
germ cell; for after the “ touching,” separate them immediately 
and observe the result. If, with the aid of powerful magnifying 
lenses, we directly examine the Spermatozoon, and continue the 
observation, wTe perceive no loss or alteration in its appearance. 
For a short time it preserves its length, breadth and thickness, 
and retains all of its material aspects. It cannot long withstand 
the seige of decay, and eventually begins to shrink; for having 
fulfilled its destiny, it loses its organic characteristics. 
19. If wre now examine the fertilized germ, and prolong the 
attention, we discover unusual activity, consequent to impregna- 
tion. Organic processes succeed each other with wonderful 
regularity, as though wwought out by inexplicable intelligence. 
Here begin the functions which constitute human physiology. 
Observation.—The act of generation requires that a 
Spermatozoon be brought In actual contact with a germ, or else 
fecundation cannot follow. Now, if spermatic cells, or the Sperm- 
atozoon, together with sevei’al unimpregnated ova — no matter 
how near to each other — be placed on the concave surface of a 
watch-crystal and covered with another crystal, keeping them 
warm, and although the vapor of the ova envelopes them, yet no 
impregnation occurs. Place the Spermatozoon in contact with 
an ovum, then seperate them as quickly as possible, and impreg- 
nation is instantly and perfectly accomplished. 
20. Is this Vitalizing power, nerve-force, electricity, heat or 
motion ? It is known that these forces may be metamorphosed; 
for nervous force may be transmuted into electricity, electricity 
into heat, heat into motion, etc., illustrating their affiliation and 
transformation. But nothing is explained as to the ultimate 
nature of the Vital principle if wTe affirm its identity with either 
of these forces; for who has revealed the ultimate nature of any 
of these, or of matter, even ? This primitive unit of conscious- 
ness, which some call sensibility, is one of the ultimate facts to 
be studied from the conditions of its manifestations; without 14 
COMMON SENSE MEDICUE ADVISER. 
these considerations we obtain no idea of it. Since it is the 
animus of the living organism, we speak of it as a vital force. 
Conceive of it as separated from these vital processes, and it 
resolves itself into an abstraction eluding all analysis. Yet it is 
a condition in the sperm cell, anterior to all concrete expression 
in the germ cell. It is an ultimate fact in the spermatic atom, 
which we term the vital principle. If it is an ideal conception, 
it begins to be real, when, with the first opportunity, it abandons 
the sperm cell and unites its destiny to a germ cell, where it finds 
favorable conditions and nourishing elements for its endless 
unfolding. The character of its development leads us to con- 
template this aggregation of forces as the representation of mind, 
as well as of formative energies. We can no more disclose the 
essence of thought than the psychologist can reveal that of the 
mind itself. The facts of science, or the conclusions of philosophy 
have no bearing in determining the after conditions, essential to 
spiritual sensibility. In our investigations we are limited to 
material circumstances. The greatest mystery is the mystery 
of all nature, manifested in that purest of dynamical energies, 
Love—, the love that displays Omnipotence. 
21. Before any observations can be made, bearing upon the 
solution of this problem, we find that organization itself must be 
subjected to its power to furnish the facts. It is this essential, 
that initiates the play of development and, at the same time 
eludes the subtleties of logicians and the cunning of thought. 
Yet it epitomizes man, the microcosm, antecedes him physically 
and psychically, and evolves him concomitantly in these relations, 
which seem a necessary prelude to final spiritual transformation. 
We know of no evolvement whatever, without this indispensable 
factor, to begin the physiology of existence. It is because of the 
imponderable, undiscoverable nature of its essence that we are 
led to call it a principle; and yet it is so specific in its conditions 
and requirements, so unswervingly an individualism as to pre- 
serve a definite relation to cause and effect. This is illustrated 
by the latent life of a kernel of wheat, which after lying dormant 
for thousands of years in the pyramids, when brought under the 
awakening influences of heat, moisture and electricity, responds 
with animation and robes itself in all the distinctive beauties of 
its pristine nature. The animal kingdom everywhere expresses THE PROCESS OE GENERATION. 
15 
the same genetic constancy. The tiny bird’s nest which holds its 
treasured wealth of four dappled eggs elucidates it, for each 
egg represents perfectly the idea of a bird, not only one 
of a particular family or species, but also the bird whose 
plumage, song and disposition distinguish it from all others. 
Faultlessly as a mix-ror reflects an image, so is this life-principle 
represented in the personality of each birdling. By it the type is 
accurately reproduced in color, grace of outline and in every part 
of the feathery organism; indeed, it modulates every thrilling 
note of joyous uttei-ance. There is, then, an occult spark of 
life, antecedent to each personality, whose empyrean is a germ 
cell. This primary gei’m contains a multitude of minute cells 
that repi’oduce, until their generative cycle is completed by 
the evolution of all the organs and functions of an individual 
body, which, in its aggregate capacities, oi-iginates other and 
similar life-principles to perpetuate the regal line of species after 
its kind. 
22. Without a conjunction of elemental forces, how can this 
unique coalition of mind and body be effected ? The properties 
of mind and matter are inseparably blended. Every process is 
double. Each function of mind has its physical effect, every 
bodily act a mental result. No thought escapes physical influ- 
ences, for however high it may soar, it must ever have an invis- 
ible continuity with brain matter and corporeal being. Formal 
thought, the highest of all the intellectual functions, implies not 
only a purely subjective factor — a conscious power which defies 
all analysis—but also an objective basis—a physical organization. 
The translation of purely mental phenomena into a system of 
atomical dynamics, reducing all the functions of the mind to 
a peculiar and ever varying molecularmotion, is a task which the 
most sanguine materialist can never hope to effectuate. Their 
relativity is a problem which philosophers, in all ages, have 
failed to solve. Within it must be contained the equation of 
Life itself. We may traverse the gloomy vestibule of sentient 
existence, even penetrate the darkened aisles of inner being, 
but into the “ holy of holies,” the sanctuary of Reason, we cannot 
enter, for its portals are guarded by the archangels of God. We 
can only know that the existence of the one is essential to the 
sacredness and maintenance of the other. That the one should 16 
COMMON SENSE MEDICAL ADVISEE. 
defy all our efforts to comprehend it, in its relations to corporeal 
being, is a sequence of human limitation, and not a result of ab- 
solute independence. It is this very relation, this balance of 
differences, which constitutes the primitive idea of an individu- 
ality. If the spiritual element is in the ascendant, in the same 
degree will the purely material be depressed, and vice versa. 
Words, the product of intelligent thought, express a double 
meaning, implied by these relations. Thoughts are spoken of as 
cold, chill and frigid, in contrast with others, warm, generous and 
glowing. Their character is described as being dull, stupid and 
doltish, or as animating, quickening and inspiring. 
Melancholy is a synonym for a gloomy, depressed and un- 
happy state of mind, borrowing all its significance from 
Melan (black) and Gholos (bile). Sweet or sour, soothing or 
irritating, may refer to mental, as well as bodily states. Spen- 
cer says: “We can think of matter only in terms of mind 
and can think of mind only in terms of matter.” We use 
words, which if separately defined and considered, will ap- 
ply with equal facility to either. Intellection, emotion and 
volition are functions of nervous matter, whose activities may 
be disclosed in the excretions. Broken down brain cells, wasted 
in the production of thought, are found in the residuum of the 
urine. 
23. Within the limits of a race the genetic principle main- 
tains a type. True, individuals of races may temporarily unite, 
hut the hybrid mixture is not permanent, and returns directly 
to the original stock. There is no intermediate race. Hybrids 
depend altogether upon the permanence of distinct types. This 
exceptional union of individuals of two races, indicates their or- 
ganic similarity, and illustrates the elasticity of the genetic 
force in thus blending, when it cannot perpetuate the hybrid 
issue. The tendency to return to the pattern types is well 
understood, and races, distinct by creation, preserve perfectly 
their organic characteristics. Experience proves that dainty 
humming birds cannot beget wrens, nor blue birds breed ra- 
pacious eagles. Skunks cannot engender guinea pigs, nor owls 
produce birds of paradise, and, finding nothing in the material 
aspects of sperm or germ cells whereon to found and preserve 
these distinctions, we refer thejn to the existence of a genetic ALTERNATE GENERATION. 
17 
principle. If the conditions which favor development are lack- 
ing, it may abort, but it cannot be refracted, or degenerated 
into something else, for we know that tadpoles never become 
foxes or mice. 
ALTERNATE GENERATION. 
24. In several insect families the species are not wholly repre- 
sented in the adult individuals of both sexes, nor in their devel- 
opment, but, to complete this representation, supplementary 
individuals (as it were) of one or of several preceding genera- 
tions are required. The son may not resemble the father but 
the grand-father, and in some instances the likeness reappears 
only in later generations. Agassiz states: 
“Alternate generation was first observed among Salpse. 
These are marine mollusks, wjthout shells, belonging to the 
family Tunicata. They are distinguished by the curious peculi- 
arity of being united together in considerable numbers so as to 
form long chains, which float in the sea, the mouth (m) however 
being free in each. 
FIG. 2. 
FIG. 3. 
Fig. 2. The individuals thus joined in floating colonies pro- 
duce eggs; but in each animal there is generally but one egg 
formed, which is developed in the body of the parent, and from 
which is hatched a little mollusk. 
Fig. 3, which remains solitary, and differs in many respects 
from the parent. This little animal, on the other hand, does not 
produce eggs, but propagates by a kind of budding, which gives 
rise to chains already seen in the body of their parent (a), and 
these again bring forth solitary individuals, etc.” 
It therefore follows that generation in some animals requires 
two different bodies with intermediate ones, by means of which, 
and, their different modes of reproduction, a return to the original 
stock is effected. 18 
COMMON SENSE MEDICAL ADVISER. 
VARIATIONS AND PERSONAL DISSIMILARITIES. 
25. Life implies simultaneous as well as successive changes. 
Two living bodies can never produce identical intermediates. 
Offspring may resemble the parents, yet there can be no stable 
transition between them, because the genetic equilibrium is 
constantly perturbating. There is no stand-still of life, but a 
constant permutation. The temperaments furnish incident forces 
which are always unequal arid varying. Differences between 
children of the same parentage are evidences of it. For these 
reasons, there is no such thing as identity between two living 
beings, whatever may be their similarity. In the vast reach of 
organic influences which connect with either parent, there have 
previously existed an infinite series of differential forces,- and 
every moment, they continue to. fluctuate. The conditions of 
generation are qualified by endless changes in the life of every 
individual parent, whose body is the organic depository of 
hereditary influences, which may crop out in succeeding or 
alternate generations. The eminent abilities of some remote 
ancestor reappear in a boy, whose immediate parentage was un- 
promising, and, under great difficulties he works his way from 
obscurity to worthy distinction, thus vindicating his patrician 
inheritance. 
26. Universality of Animalcular life.—The ge- 
netic elements are universally diffused. The gentle zephyr wafts 
from flower to flower, invisible, fructifying atoms, which quicken 
beauty and fragrance giving the promise of a golden fruitage, to 
gladden and nourish a dependent world. Nature’s own sweet 
cunning invests all living things, constraining into her service 
chemical affinities, arranging and disposing of the elements for 
her own benefit in such numberless ways, that we involuntarily 
exclaim, 
“The course of Nature is the art of God.” 
The microscope reveals the fact that matter which measures 
only of a line in diameter is endowed with vitality, and count- 
less numbers of animalcula inhabit a single drop of water. These 
monads do not vary in form, whether in motion or at rest. The 
life of one, even, is inexplicable to the philosopher. The sphere 
of vitality expands before our eyes. Erenberg writes: “Not only ORIGIN OP LIFE. 
19 
in the polar regions is there an uninterrupted development of 
active microscopic life, where larger animals cannot exist, but 
we find that those minute beings collected in the Antarctic ex- 
pedition of Captain James Ross, exhibit a remarkable abundance 
of unknown, and often most beautiful forms.” 
Even the interior of animal bodies is inhabited by animal- 
cules. They have been found in the blood of the frog and 
salmon and in the optic fluids of fishefe. Organic beings are 
found in the interior of the earth, in which the industry of the 
miner has laid open extensive excavations, sprung deep shafts, 
and thus revealed their forms; likewise, the smallest fossil or- 
ganisms form, in humid districts, subterranean strata many fath- 
oms deep. Not only does life abound in lakes and inland seas, 
but also from unknown depths, in volcanic districts, arise 
thermal springs which contain living insects,—real animalcular 
salamanders. Were we endowed with the eye of the micro- 
scope, we might see myriads of ethereal voyagers, wafted by 
every breeze, as we now behold drifting clouds of aqueous 
vapor. While the continents of earth indicate the universality 
of organic beings, recent observations prove that, “animal life 
predominates amid the eternal night of the depths of the 
liquid ocean.” 
ORIGIN OF LIFE. 
27. The ancients, crude in many of their ideas, referred the 
origin of life to Divine determination. The thought was rudely 
expressed, and well represented in the following verse: 
“Then God smites his hands together, 
And strikes out a soul as a spark, 
Into the organized glory of things, 
From the deeps of the dark.” 
According to a Greek myth, Prometheus made a human image 
from the dust of the ground, and then, by fire stolen from 
heaven, animated it with a living soul. Spontaneous generation 
once held its sway, and now the idea of a natural evolution is pop- 
ular. Some believe that the impenetrable mystery — life — is 
evolved from the endowments of nature, since we are restricted 
in our observations to its concrete forms and their manifesta- 
tions. Yet every function indicates purpose, every organization 20 
COMMON SENSE MEDICAL ADVISEE. 
evinces intelligent design, and all, proclaim a Divine Power. 
Something cannot come out of nothing. With reason and 
philosophy, chance is an impossibility. We therefore accept 
the displays of wisdom in nature, as indicative of the designs of 
God. Thus “has He written His claims for our profoundest 
admiration and homage all over every object that He has 
made.” If you ask, is there any advantage in considering the 
phenomena of nature as the result of Divine Volition, we 
answer, that this belief corresponds to the universally acknowl- 
edged ideas of accountability; for, with a wise and efficient 
Cause, we infer there is an intelligent creation, and the desire 
to communicate, guide and bless, is responded to by man, wdio 
loves, obeys and enjoys. Nothing is gained by attributing to 
nature vice-gerent forces; is it not preferable to say that she 
responds to intelligent, loving, Omnipotence? Our finiteness is 
illustrated by our initiation into organized being. Emerging 
from a ray less atom, too diminutive for the sight, we gradually 
evolve and advance to the maturity of those Conscious Powers, 
the exercise of which furnishes subjective evidence of our im- 
mortality. We are pervaded with invisible influences which, 
unconsciously, like the needle of the compass trembling on its 
pivot, point us to immortality as the ultimate goal, where, in the 
sunny clime of Love, even in a spiritual realm of joy and 
happiness, we may eternally reign with Him, Who is All in All. CHAPTER II. 
PHYSIOLOGICAL ANATOMY. 
THE BONES. 
28. All living bodies are made up of tissues. There is no 
part, no organ, however soft and yielding, or hard and resisting, 
which has not this peculiarity of structure. Tissues belong to 
the bones of animals as well as to their flesh and fat, and all 
alike, originate from cells. Each cell discloses a triple organi- 
zation, viz: a nucleolus, or dark spot, in the centre of the cell, 
around which circles a mass of granules called the nucleus/ and 
this, in turn, is surrounded with a delicate, transparent mem- 
brane, termed the envelope. Each of the granules, composing 
the nucleus, appropriates nourishment, thereby growing into an 
independent cell, which possesses the same triple organization 
as its parent, and in like manner reproduces 
other cells. 
A variety of tissues enter into the composition 
of an animal structure, yet their differences are 
not always distinctly marked, since the character- 
istics of some are not unlike those of others. We 
shall notice, however, only the most important of 
the tissues. 
The Areolar tissue is a complete network of 
delicate fibres, spread over the body, and its in- 
numerable interstices are filled with a fluid. The 
fibrous and serous tissues are only modifications 
of the areolar. 
Fig. 4- 
Nucleated cell. 
FromGoeber. 1. 
Periphery of the 
cell, or cell-wall; 
2. Nucleus; 3. 
Nucleolus in the 
centre. 22 
COMMON SENSE MEDICAL ADVISEE. 
The Nervous tissue is of two 
kinds, viz: the grey colored, which 
is pulpy and granulated, and the 
white fibrous tissue. Adipose tissue, 
is a membrane of extreme tenuity, 
and composed of closed cells which 
contain fat. It is found directly 
beneath the skin, giving it a 
smooth, plump appearance. 
The Cartilaginous tissue 
consists of nucleated cells, 
and with the exception of 
bone, is the hardest part of 
the animal frame. The Os- 
seous (or bone) tissue is more 
compact and solid than the 
cartilaginous, for it contains 
a greater proportion of lime. 
The Muscular tissue is composed of bundles of fibres which are 
inclosed in a cellular membrane. 
29. Various opinions have been entertained in regard to the 
forming processes or growth of bone. Some have erroneously 
supposed that all bone is formed in cartilage. But this is not 
true; for there is an intra-membranous, as well as an intra- 
cartilaginous formation of bone, as seen in the development 
of the cranial bones, where the progressive calcification takes 
place upon the inner layers of the fibrous coverings. Intra- 
cartilaginous deposit is found in the vicinity of the blood 
vessels, within the cartilaginous canals; also there are certain 
incipient points first observed in the centres of long called 
points of ossification. These points are no sooner formed than 
the cartilage-corpuscles arrange themselves in a linear series, 
and, lying in contact with each other, become very compact. 
As ossification proceeds, the cup-shaped cavities are converted 
into closed interstices of bone with extremely thin lamellae. 
These, however, soon thicken, and no closed vessels can be 
Fig. 5. 
Fig. 6. 
Arrangement of Fibres in Areolar 
Tissue. Magnified 135 diameters. 
Human Adipose Tissue. THE BOKES. 
23 
traced within them. The bony plates define the boundaries 
of the Haversian canals. In the second stage of ossification 
the cartilage- 
corpuscles are 
converted into 
bone. Becom- 
ing flattened 
against the os- 
seous lamellae 
already form- 
ed, they crowd 
upon each 
other so as*to 
entirely oblit- 
erate the lines 
that d i s t i n- 
guish them, 
and, simulta- 
neously with 
Thigh-bone, 
tilCS6 changes, sawn open 
a calcareous k''lgthwlse- 
deposit takes place 
upon their interior. 
Bones grow in a longi- 
tudinal direction. Their 
extremities are separated 
from the body of the 
Fig. 8. 
Fig. 7. 
Fig. 9. 
Vertical section of Cartilage near the surface of 
ossification; 1, ordinary appearance of the tempor- 
ary cartilage; V, portion of the same more highly 
magnified; 2, the cells beginning to assume the 
linear direction; 3', portion more magnified; oppo- 
site 3, the ossification is extending in the intercell- 
ular spaces, and the rows of cells are seen resting 
in the cavities so formed, the nuclei being more 
separated than above; 3', portion of the same more 
highly magnified. 
Lower end of the thigh-bone, 
sawn across, showing its cen- 
tral cavity. 
bone by a lamina of car- 
tilage, and the, cancel- 
lated structure, which 24 
COMMON SENSE MEDICAL ADVISER. 
remains for a time in their interior, represents the early condition 
of the ossifying substances. 
30. The bones contain more earthy matter in their composi- 
tion than any other part of the human body, being firm, hard, 
and of a lime color. They compose the skeleton frame-work, 
and when united by natural ligaments, form what is known as 
the natural skeleton. When wired together, they are called an 
artificial skeleton. The number of bones in the human body 
is variously estimated; for those regarded as single by some 
anatomists, are described by others as consisting of several 
pieces. There are about two hundred and eight bones in the 
human body, besides the teeth. These may be divided into 
those of the Head, Trunk, Upper and Lower Extremities. 
31. TllC Hones OI the Mead are enumerated as 
follows: six belonging 
to the Cranium, four- 
teen to the Face, two 
common to both Head 
and Face, and four to 
the Ear. The Cranium 
(skull) is formed of two 
bony plates, between 
which is placed a spongy 
bone. The external plate 
is fibrous, the internal, 
compact and vitreous. 
The skull, from its con- 
struction, is admirably 
adapted to resist any 
injury to which it is 
exposed. It is nearly 
oval in form, convex ex- 
ternally, much thicker 
at the base than else- 
where, and is well fitted 
to protect the brain sub- 
stance which it envel- 
ops. The internal sur- 
face of the cranium 
Fig. 10. 
The hones of the skull separated. 1. Frontal, 
only half is seen. 2. Parietal (wall). 3. Occipital 
(back) only half is seen. A. Temporal. 5. Kasai 
(nose). 6. Malar (cheek). 7. Superior (upper) 
maxillary (jaw). 8. Unguis (nail form, being about 
the size and thickness of the finger nail). 9. In- 
ferior (lower) maxillary (jaw). Between A and 6 a 
part of the sphenoid, or wedge-shaped bone, is 
seen. Another bone assisting to form the skull, 
but not here seen, is called the ethmoid (sieve like 
from being full of holes) and situated between the 
sockets of the eyes, forming the roof of the nose. 
2, A, 5, 6, 7, 8 are double. The small bone, and 
others like it, seen in a line between 3 and A, are 
called ossa triquetra. THE TRUNK. 
25 
presents little pathways, more or less irregular in their course, 
which are the grooves for blood vessels. The bones of the cra- 
nium are united to each other, and to those of the face, by ragged 
edges, called sutures. Although quite distinct in the adult, in 
old age, they are nearly effaced. Some suppose that by this 
arrangement, the cranium is less liable to be fractured by blows; 
others think that the sutures allow the growth of these bones, 
which takes place by osseous enlargements at their margins. 
The bones of the Face articulate at the lower part and in front 
of the cranium, and serve for the attachment of powerful muscles 
which assist in the process of mastication. Although the soft 
parts of the face cover the bony structure, yet they do not con- 
ceal its principle features, or materially change its proportions. 
The form of the head and face presents some remarkable dis- 
similarities in different races. The bones of the Far retain in 
a normal position, the several parts required for hearing. 
32. The Trunk has fifty-four bones, viz: the Os hyoides, 
the Sternum, twenty-four Ribs, 
twenty-four of the Spinal col- 
umn, and four bones of the 
Pelvis. The Os hyoides, situ- 
ated at the base of the tongue, 
is the most isolated bone of 
the skeleton, and serves for the 
attachment of muscles. The 
Sternum (breast bone), in 
childhood, is composed of 
eight pieces, in the adult, of 
three, and in old age these 
are consolidated into one bone. 
The Hibs are thin, curved 
bones, convex externally, con- 
cave internally, and situated 
immediately between the 
sternum in front, and the 
spinal column behind. There 
are twelve on each side. The 
seven upper ribs, which are 
united to the sternum, are 
Fig. 11. 
1. The first bone of the sternum (breast 
bone). 2. The second bone of the sternum. 
S. The cartilage of the sternum. 4. The 
first dorsal vertebra (a bone of the spinal 
column). 5. The last dorsal vertebra. 6. 
The first rib. 7. Its head. 8. Its neck. 9. 
Its tubercle. 10. The seventh or last true 
rib. 11. The cartilage of the third rib. 12. 
The floating ribs. 26 
COMMON SENSE MEDICAL ADVISEE. 
termed true ribs; the next three, which are not attached to the 
sternum, hut to each other, are called false ribs; 
and the last two, which are joined only to the 
vertebrae, are designated as floating ribs. Of 
the true ribs, the first one is the shortest, and 
they increase in length as far as the eighth, 
after which the order is reversed. 
The Spinal Column (back hone) when viewed 
from the front, pre- 
sents a perpendicu- 
lar appearance, hut a 
side view shows four 
distinct natural cur- 
vatures. The hones 
composing it are call- 
ed vertebrae. The 
body part of a verte- 
bra is light and spon- 
gy in texture, having 
seven projections 
called processes, four of which are the articu- 
lating processes, furnishing surfaces to join 
the different vertebrae of the spinal column. 
Two are called trans- 
verse, and the other, 
is termed the spinous. 
The transverse and 
spinous processes, 
serve for the attach- 
ment of the muscles 
belonging to the back. 
All these processes 
are more compact than 
the body of the ver- 
tebra, and when nat- 
urally connected, are 
so arranged as to form 
a tube which contains 
the medulla spinalis (spinal cord). 
Fig. U. 
Fig. 12. 
A vertebra of the neck. 1. The 
body of the vertebra. 2. The spi- 
nal canal. 4. The spinous process, 
cleft at its extremity. 5. The 
transverse process. 7. The in- 
ferior articulating process. 8. 
The superior articulating process. 
Fig. 13. 
Batik-bone, spinal 
column or vertebral 
column. All ani- 
mals possessing 
such a row ol bones 
are called verte- 
brates. Above b, 
are the cervical 
(neck) vertebra; b 
to c, dorsal (back) 
or chest vertebra; 
c to d lumbar(loius) 
vertebra; d, e, sa- 
crum; e,f, coccyx. 
1. The cartilaginous substance 
which connects the bodies of the 
vertebra. 8. The body of the 
vertebra. 8. The spinous process. 
It, It. The transverse processes. 
5, 5. The articulating processes. 
6, 6. A portion of the bony bridge 
which assists in forming the spi- 
nal canal, (7). BONES OF THE UPPER EXTREMITIES. 
27 
Between the vertebne is a highly elastic, cartilaginous and 
cushion-like substance, which freely admits of motion, and 
allows the spine to bend as occasion requires. The natural 
curvatures of the spinal column diminish the shock (produced by 
walking, running or leaping,) which would otherwise be more 
directly communicated to the brain. 
The ribs at the sides, the sternum in front, and the twelve 
dorsal bones of the spinal column behind, bound the thoracic 
cavity which contains the lungs, heart and large blood vessels. 
33. Tlie Pelvis is an open bony structure, consisting of 
the Os Innominatum 
at either side, and the 
Sacrum and Coccyx 
behind. The Sacrum, 
during childhood, con- 
sists of five bones, and 
these, in later years, 
unite to form one bone. 
It is light and spongy 
in texture, and the 
upper surface articu- 
lates with the lower 
vertebra, wdiile it is 
united by the inferior 
margin to the coccyx. 
The Coccyx is the terminal bone of the spinal column. In 
infancy it is cartilaginous and composed of several pieces, but 
in the adult, these unite and form one bone. The Innominata 
(nameless bones), consist of three symmetrical pieces on each 
side, in the youthful period, but in the adult they coalesce, 
forming one bone. A deep socket, called the acetabulum, is 
found near their junction, and serves for the reception of the 
head of the thigh-bone. 
Fig. 15. 
A representation of the pelvic bones, e. The 
sacro-Iumbar joint. 2. The sacrum. 3. Coccyx. 1,1. 
The innominata. 4, 4. Acetabulum, or hip joint. 
The Bones of the Upper Extremities are 
sixty-four in number and arranged under the following divi- 
sions, viz: The Scapula, the Clavicle, the Humerus, the Ulna 
and Radius, the Carpus, Metacarpus and Phalanges. The 
Scapula (shoulder blade) is an irregular, thin, triangular- 
shaped bone, situated at the posterior part of the shoulder, 28 
COMMON SENSE MEDICAL ADVISER. 
and attached to the upper and back part of the chest. The 
Clavicle, (collar bone) is located at the upper part of the 
chest, between the sternum 
and scapula, and connects 
with both. Its form be- 
ing that of the italic letter 
/S, it prevents the arms 
from sliding forward, and 
the person from becoming 
round shouldered. The 
Humerus (first bone of the 
arm), is long, cylindrical- 
ly shaped, and interposed 
between the scapula and 
fore-arm. The Ulna (bone 
of the fore-arm), is nearly 
parallel to the radius, and 
situated on the inner side 
of the fore-arm. It is the 
longer, and larger of the 
two bones, and in its artic- 
ulation with the humerus, 
forms a complete hinge- 
joint. The Radius,— a 
“ spoke,”—so called from 
its shape, is on the outside 
of the fore-arm, and artic- 
ulates with the bones of 
the wrist, forming a joint. 
The ulna and radius also 
articulate with each other 
at their extremities. The 
Carpus (wrist) consists of 
eight bones arranged in 
two rows. The Meta- 
carpus (palm of the hand) 
is composed of five bones, situated between the carpus and fingers. 
The Phalanges (fingers and thumbs) comprise fourteen bones, 
the fingers having three series, while the thumb has but two. 
Fig. 16. 
1,1. Portions of the back bone. 2. Cranial bones. 
4. Breastbone. 5. Ribs. 7. Collarbone. 8. Arm 
bone (humerus). 9. Shoulder joint. 10,11. Bones 
of the fore-arm (ulna and radius). 12. Elbow 
joint. 13. The wrist joint, 1U. Bones of the hand. 
15, 16. Pelvic bones. 17. Hip joint. 18. Femur. 
19, 20. Bones of the knee joint. 21, 22. Fibula 
and Tibia. 23. Ankle bone. 2h. Bones of the foot. BONES OF THE LOWER EXTREMITIES. 
29 
34. The hones of the Lower Extremities, (of 
which there are sixty,) may he classified as follows: The Femur, 
Patella, Tibia, Fibula, Tarsus, Metatarsus, and Phalanges. The 
Femur (thigh-bone) is the longest bone in the body. It has a 
large circular head, which is received into the acetabulum, thus 
affording a good example of the ball and socket joint. The 
Patella (knee-pan) presents the most complicated articulation 
of the body. It is of a rounded form,, connects with the tibia 
by means of a strong ligament, and serves as a pully when 
the limb is extended. The Tibia (shin-bone) is enlarged at each 
extremity to articulate with the femur above, and the astragalus 
below. The Fibula (small bone of the leg) is situated at the 
outside of the tibia, and firmly bound to it at each extremity. 
The Tarsus (instep) is composed of seven bones, and corresponds 
to the carpus of the upper extremities. The Metatarsus (middle 
of the foot) bears a close resemblance to the metacarpus, and 
consists of five bones interposed between the tarsus and phalan- 
ges. The tarsal and metatarsal bones are united, so as to give 
an arched appearance to the foot, thus imparting elasticity. The 
Phalanges (toes) consist of fourteen bones, arranged in a manner 
similar to that of the fingers. 
Not less are we intei’ested in tracing the formation of bone 
through its several stages, than in considering other parts of the 
human system. The formation of Haversian canals for the 
passage of blood-vessels to nourish the bones, and the earlier 
construction of bony tissue by a metamorphosis of cartilaginous 
substance, as well as the commencement of ossification at dis- 
tinct points, called centres of ossification, are all important 
matters, requiring the student’s careful attention. The bones 
are protected by an external membranous envelope, which, from 
the nature of its function, is called the Periosteum. The bones 
are divided into long and round, short and thick, or, broad and 
fiat, being adapted to subserve a variety of purposes. The long 
bones are required for locomotion; where a covering for the 
delicate organs is necessary, the flat bones are provided, as the 
skull, etc.; where strength and motion are both essential, as in 
the vertebrae, short bones are furnished. 
35. The construction and arrangements of the hones are 
highly curious. The formation of joints requires not only bones, 30 
COMMON SENSE MEDICAL ADVISEE. 
but cartilages, ligaments and the synovial membrane to complete 
the articulations. Cartilage is a smooth, elastic substance, softer 
than bone, and invested with a thin membrane called Perichon- 
drium. When cartilage is placed upon convex surfaces, it is 
thickest at their centres, while upon concave surfaces, the reverse 
is true. The ligaments are white, inelastic, tendinous substances 
softer than cartilage, but harder than membrane. Their function 
is to bind together the bones. The Synovial membrane covers 
the cartilages, and is then reflected upon the ligaments, thus 
forming a thin, closed sac. 
Fig. 18. 
Fig. 17. 
Anatomy of the knee joint. 
1. Lower end of thigh-bone. 
8. Knee-pan. 2, 4. Liga- 
ments of the knee-pan. 5. 
Upper end of the Tibia or 
shin-bone. 6,12. Cartilages. 
Anatomy of a joint. 1, 1. 
Bonesof ajoint. 2,2. Cover- 
ed by cartilage. 3, 3, 3, 3. 
Synovial membrane. 
All synovial membranes secrete a lubricating fluid termed 
synovia, which enables the surfaces of the bones and ligaments 
to move freely upon each other. When this fluid is secreted in 
excessive quantities, it produces a disease known as “ dropsy ” of 
the joints. There are numerous smaller sacs besides the syno- 
vial, called Bursae Mucosae, which in structure are analogous to 
it, and secrete a similar fluid. Some joints permit motion in 
every direction, as the shoulders, some in two directions only, as 
the elbows, while others do not admit of any movement. The 
bones, ligaments, cartilages, and synovial membrane are supplied 
with nerves, arteries, and veins. 
36. When an animal is provided with an internal bony 
structure, it indicates a high rank in the scale of organization. 
An elaborate texture of bone is found in no class below the BONES OF THE LOWER EXTREMITIES. 
31 
vertebrates. Even in the lower order of this sub-kingdom—which 
is the highest of animals — bone is not found, as is true in some 
tribes of fishes, sharks, etc.; and in all classes below that of the 
cartilaginous fishes, the inflexible substance which sustains the 
soft parts is either shell or some modification of bone, and is found 
upon the external surface of the body. True bone, on the con- 
trary, is placed upon the interior, and therefore, in higher animals, 
the skeleton is always internal, while the soft parts are placed 
externally to the bony frame. While many animals of the lowest 
species, being composed of soft gelatinous matter, are buoyant 
in water, the highest type of animals, require not only a bony, 
but also a flexible, muscular system for locomotion in the water 
or upon the land. Each species of the animal kingdom is thus 
organically adapted to its condition and sphere of life. CHAPTEE III. 
PHYSIOLOGICAL ANATOMY. 
THE MUSCLES. 
37. I he Muscles are those organs of the body by which 
motion is produced, and are commonly known as flesh. A muscle 
is composed of fasiculi (bundles of fibres), parallel to each other. 
They are soft, variable in size, of a reddish color, and inclosed in 
a cellular, membranous sheath. Each fasciculus contains a num- 
ber of small fibres, which, when subjected to a microscopic 
examination, are found to consist of fibrillce (little fibres), each, 
in turn, being invested with a delicate sheath. 
The fibres terminate in a glistening, white 
tendon (hard cord) which is attached to the 
bone. So firmly are they united, that the bone 
will sooner break than the tendon release its 
hold. When the tendon is spread out, so as 
to resemble a membrane, it is called Fascia. 
Being of various extent and thickness, it is 
distributed over the body, as a covering and 
protection for the more delicate parts, and 
aids also in motion by firmly uniting the mus- 
cular fibres. The spaces between the muscles 
are filled with fat, which gives roundness and 
beauty to the limbs. The muscles vary in 
their forms; some are longitudinal, each extremity terminating 
in a tendon which gives them a fusiform or spindle-shaped ap- 
pearance; others are either fan-shaped, flattened or cylindrical. 
Fig. 19. 
Muscular fibres highly 
magnified. THE MUSCLES. 
33 
38. Every muscle has an origin and insertion. The origin is 
the fixed and central point; the insertion is the movable point, 
and farthest from the centre. 
The muscles are divided into 
the voluntary, or muscles of 
animal life, and the involun- 
tary or muscles of organic 
life. There are, however, 
some muscles which cannot 
he properly classified with 
either, and may be termed 
intermediate. The voluntary, 
are controlled chiefly by the 
will, relaxing and contracting 
at its pleasure, as in the motion 
of the eyes, ears, limbs, etc. 
The fibres are of a dark red 
color, and possess great strength. These fasciculi are parallel, 
seldom interlacing, but presenting a striped or striated appear- 
ance. A microscopic examination of these fibres shows that the 
most minute, consist of 
parallel filaments mark- 
ed by longitudinal and 
transverse striae. The 
striated fibres are of 
nearly the same length 
as the muscles to which 
they belong. Each mus- 
cular fibre is capable of 
contraction; it may act 
singly, though usually 
it acts in concert with 
others. By a close in- 
spection it has been 
found that fibres may be 
drawn apart longitudi- 
nally, in which case they are termed fibrillce, or they may be 
separated transversely, forming a series of discs. The Sarco- 
lemma, or investing sheath of the muscles, appears to have been 
Fig. 20. 
1. A represention of a spindle-shaped 
muscle, with tendinous terminations. 2. 
Fan-shaped muscle. 3. Penniform muscle. 
It. Bipenniform muscle. 
Fig. 21. 
Striped muscular fibres, showing cleavage In op- 
posite directions. 1. Longitudinal cleavage. 2. 
Transverse cleavage. 3. Transverse section of disc. 
4. Disc nearly detached. 5. Detached disc showing 
the sarcous elements. 6. Fibrillse. 7, 8. Separated 
fibrillaB (highly magnified). 34 
COMMON SENSE MEDICAL ADVISEE. 
formed even before there were any visible traces of the muscle 
itself. It is a transparent and delicate, but very elastic membrane. 
39. The involuntary muscles are influenced by the sympa- 
thetic system, and their actions pertain to the nutritive functions 
of the body. They differ from the volun- 
tary, by being non-striated, having no ten- 
dons, and by the net-work arrangement of 
their fibres. The intermediate muscles 
are composed of striated and non-striated 
fibres; they are therefore both voluntary 
and involuntary in their functions. The 
muscles employed in respiration are of this 
class, for we can breathe rapidly or slowly, 
and for a short time, suspend their action 
altogether; soon, however, the organic 
muscles assert their instinctive control, 
and respiration is resumed. 
40. The Diaphragm, (midriff) 
is the muscular division between the thorax 
and abdomen. It has been compared to 
an inverted basin, its concavity being di- 
rected toward the abdomen. 
Fig. 22. 
Non - striated Muscular 
Fibre; at b, in its natural 
state; at a, showing the 
nuclei after the action of 
acetic acid. 
Fig. 23. 
The muscles are 
nourished by blood 
vessels so arranged 
as to form a complete 
net-work. The volun- 
tary, are abundantly 
supplied with nerves, 
while the involunta- 
ry, are not so numer- 
ously furnished. The 
color of the muscles 
is chiefly due to the 
blood. They vary 
in size according to 
A view of the under side of the diaphragm, which is 
the muscular division between the thorax and abdomen. TIIE MUSCI.ES. 
35 
Fig. %J/.. 
A representation of the superficial layer of muscles on the anterior 
portion of the body. COMMON SENSE MEDICAL ADVISER. 
their use. For example, the functions of the heart require large 
and powerful muscles, while those of the eye, small and delicate 
ones. There are from four hundred and sixty, to five hundred 
muscles in the human body. 
41. Very rarely is motion produced by the action of a single 
muscle, but by a “composition of forces.” There is an infinite 
variety in the arrangements of muscular fibres, according to the 
requirements of each, whether it be strength, tenacity, or rapid- 
ity. While some involuntarily respond to the wants of the 
organization, others obey, with mechanical nicety, the edicts of 
the will. The peculiar characteristic of the muscles is their 
contractility: for example, when the tip of the finger is placed 
in the ear, the sound of their incessant vibration can be heard. 
When the muscles contract, they become shorter and thicker, but 
what is lost in length is gained in breadth and thickness, so 
that their actual volume remains the same. Muscles alternately 
contract and relax, and thus act upon the bones. The economy 
of muscular power thus displayed is truly remarkable. In easy 
and graceful walking, the forward motion of the limbs is not 
altogether owing to the exercise of muscular power, but to the 
force of gravity, and only a slight assistance of the muscles is 
required to elevate the leg sufficiently to allow it to oscillate. 
42. Motion is a characteristic of living bodies. This is true, 
not only with regard to animals, but also with plants. The 
oyster, although not possessing the power of locomotion, yet 
opehs and closes its shell at pleasure. The coral insect appears 
at the door of its cell, and then retreats at will. The most ob- 
vious motions of animals are due to that distinguishing property 
of the muscles, viz., contractility. Plants, although influenced 
by external agents, as light, heat, electricity, etc., yet it cannot 
be denied that they move in response to vitilizing impulses. 
The sensitive stamens of the barberry, when touched at their 
base on the inner side, intuitively resent the intrusion, by mak- 
ing a sudden jerk forward. The Venus fly-trap, found in 
JSTorth Carolina, is provided with an apparatus for catching insects, 
and actually succeeds in capturing them by a sudden motion, which 
shows the superadded quality of sensitiveness, similar to volition. 
The muscles of the Articulates are situated within the solid 
framework, unlike the Vertebrates, whose muscles are external THE MUSCLES. 
37 
Fig. 25. 
A representation of the superficial layer of muscles on the posterior 
portion of the body. 38 
COMMON SENSE MEDICAL ADVISER. 
to the bony skeleton. All animals have the power of motion, 
from the lowest Radiate to the highest Vertebrate, from the 
most repulsive Polyp, to that type of organized life made in the 
very image of God. 
43. The muscles, then, subserve an endless variety of pur- 
poses. By their aid the farmer employs his implements of 
husbandry, the mechanic deftly wields his tools, the artist, with 
accomplished skill, plies his brush, while the fervid orator, by 
their aid, gives utterance to thoughts glowing with heavenly 
emotions. It is by their agency that the subliinest spiritual 
conceptions can be brought to the sphere of the senses, and 
the noblest, loftiest aims of to-day can be made the glorious 
realizations of the future. CHAPTER IV. 
PHYSIOLOGICAL ANATOMY. 
THE DIGESTIVE ORGANS. 
44. Digestion signifies the act of separating or distributing, 
hence its application to the process by which food is made avail- 
able for nutritive purposes. The organs of digestion are the 
Mouth, Teeth, Tongue, Salivary Glands, Pharynx, Esophagus, 
Stomach, Intestines, Lacteals, Thoracic Duct, Liver, Spleen and 
Pancreas. 
45. The Mouth is an irregular cavity situated between the 
upper and lower jaws, and contains the organs of mastication. 
If is bounded by the lips in front, the cheeks at the sides, the 
roof of the mouth and teeth of the upper jaw above, and behind 
and beneath by the teeth of the lower jaw, soft parts and palate. 
The soft palate is a sort of 
pendulum attached only at one 
of its extremities, while the other 
involuntarily opens and closes 
the passage from the mouth to 
the pharynx. The interior of 
the mouth — as w'ell as other 
portions of the alimentary canal 
— is lined with a delicate tissue, 
called mucous membrane. 
46. The Teeth are firmly in- 
serted in the alveolar sockets of 
the upper and lower jaws. The 
first set — twenty in number — 
Fig. 26. 
A view of the lower jaw. 1. The body. 
2, 2. Kami or branches. 3, 3. Processes of 
the lower jaw. m. Molar teeth, b. Bi- 
cuspids. c. Cuspids, i. Incisors. 40 
COMMON SENSE MEDICAL ADVISER. 
are temporary and appear during infancy. They are replaced 
by permanent teeth, of which there are sixteen in each jaw, viz: 
four incisors (front teeth), four cuspids (eye teeth), four bicus- 
pids (grinders), and four molars (large grinders). Each tooth 
is divided into the crown, body and root. The crown is the 
grinding surface; the body,— the part projecting from the jaw 
— is the seat of sensation and nutrition; the root is that por- 
tion of the tooth which is inserted in the alveolar socket. The 
teeth are composed of dentine (ivory) and enamel. The ivory 
forms the greater portion of the body and root, while the enamel 
covers the exposed surface of the teeth. The small white cords 
communicating with the teeth are called nerves. 
47. Ihe Tongue is a flattened, oval organ, the base of which 
is attached to the os hyoides, while the apex (the most sensitive 
part of the body) is free. Its surface is covered with a mem- 
brane, which at the sides and lower part, is continuous with the 
lining of the mouth. On the lower surface of the tongue, this 
membrane is thin and smooth, but on the upper, it is covered 
with numerous papillae, which, in structure, are similar to the 
sensitive papillae of the skin. 
48. The Saliva- 
ry Glands are six 
in number, three 
on each side of the 
mouth; their func- 
tion is to secrete 
a fluid called sali- 
va., which aids in 
mastication. The 
largest of the 
glands — the Pa- 
rotid—is situated 
in front and below 
the ear; its struc- 
ture, like that of 
all the salivary 
glands, is cellular. 
The Submaxillary 
gland is circular in form, and situated midway between the angle 
Fig. 27. 
The salivary glands. The largest one near the ear is the 
parotid gland. The next below it is the submaxillary 
gland. The one under the tongue is the sublingual gland. THE DIGESTIVE ORGANS. 
41 
of the lower jaw and the middle of the chin. The Sublingual 
is a long flattened gland, and, as its name indicates, is located 
below the tongue, which, when elevated, discloses the saliva 
issuing from the porous openings. 
49. The Pharynx is nearly four inches in length, formed of 
muscular and membranous cells, and situated between the base 
of the cranium and esophagus, in front of the spinal column. 
It is narrow at the upper part, distended in the middle, but con- 
tracting again at its junction with the esophagus. The pharynx 
communicates with the nose, mouth, larynx and stomach. 
50. The Esophagus, a cylindrical organ, is a continuation of 
the pharynx, and extends through the diaphragm to the stomach. 
It is composed of three coats: first, the muscular, consisting of 
an external layer of fibres running longitudinally, and an in- 
ternal layer of transverse fibres; second, the cellular, which is 
interposed between the muscular and mucous coats; third, the 
mucous membrane, or internal coat, which is continuous with the 
mucous lining of the pharynx. 
51. The Stomach is a musculo-membranous, conoidal-shaped 
sac, communicating with 
the esophagus, by means 
of the cardiac orifice. It 
is situated obliquely with 
reference to the body, its 
base lying at the left side, 
while the apex is directed 
toward the right side. 
The stomach is between 
the liver and spleen, sub- 
jacent to the diaphragm, 
and communicates with 
the intestinal canal by 
the pyloric orifice. It has 
three coats. The perito- 
neal, or external coat is composed of compact, cellular tissue, 
woven into a thin, serous membrane, and assists in keeping the 
stomach in place. The middle coat is formed of three layers of 
muscular fibres; in the first, the fibres run longitudinally; in the 
second, in a circular direction; while in the third, they are placed 
Fig. 28. 
A representation of the interior of the stomach. 
1. The esophagus. g. Cardiac orifice opening into 
the stomach. 6. The middle or muscular coat. 
7. The interior or mucous coat. 10. The beginning 
of the duodenum. 11. The pyloric orifice. 42 
COMMON SENSE MEDICAL ADVISER. 
obliquely to the others. The interior or mucous coat lines this 
organ. The stomach has a soft, spongy appearance, and when 
not distended is in folds; during life it is, ordinarily, of a pinkish 
color. It is provided with numerous small glands, which secrete 
the gastric fluid necessary for the digestion of food. The lining 
membrane, when divested of mucus, presents a wrinkled appear- 
ance. The arteries, veins, and lymphatics of the stomach are 
numerous. 
52. The Intestines are those convoluted portions of the ali- 
mentary canal into which the food is received after being partially 
digested, where the separation 
and absorption of the nutritive 
materials and the removal of the 
residuum takes place. The coats 
of the intestines are analogous 
to those of the stomach, and 
are, in fact, only extensions of 
them. For convenience of de- 
scription, the intestines may be 
divided into the small and 
large. The small intestine is 
from twenty to twenty-five feet 
in length, and consists of the 
Duodenum, Jejunum, and Ileum. 
The Duodenum — so called be- 
cause its length is equal to the 
breadth of twelve fingers—is the 
first division of the small intes- 
tine. If the mucous membrane 
of the duodenum be examined, 
numerous villi will be found 
upon its internal surface. Each 
villus consists of a network of 
blood vessels, and a lacteal 
tube, into which the ducts from the liver and pancreas open, and 
furnish their secretions to assist in the conversion of the chyme 
into chyle. The Jejunum — so named because usually found 
empty after death — is a continuation of the duodenum, and is 
that portion of the alimentary canal, wheTe the absorption of 
Fig. 29. 
Small and large intestines. 1, 1, 2, 2. 
Small intestine. 3. Its termination in the 
large intestine. 4. Appendicula vermi- 
formis. 5. Ctecum. 6. Ascending colon. 
7. Transverse colon. 8. Descending colon. 
9. Sigmoid flexure of colon. 10. Rectum. THE DIGESTIVE ORGANS. 
43 
nutritive matter is chiefly effected. The Ileum (signifying to 
roll up) is the longest division of the small intestine ; although 
somewhat thinner in texture 
than the jejunum, yet the 
difference is scarcely percept- 
ible. The large intestine is 
about five feet in length, and 
is divided into the Caecum, 
Colon, and Rectum. The 
Caecum is about three inches 
in length. Between the large 
and small intestines is a valve, 
the function of which is to 
prevent the return of excre- 
mentitious matter, that has 
passed into the large intes- 
tine. There is attached to 
the caecum an appendage about the size of a goose quill, and 
three inches in length, termed appendicula vermiformis. The 
Colon is that part of the large intestine which extends from the 
caecum to the rectum, and is 
divided into three parts, dis- 
tinguished as ascending, 
transverse and descending. 
The Hectum is the terminus 
of the large intestine. The 
intestines are abundantly 
supplied with blood vessels. 
The arteries of the small in- 
testine are from fifteen to 
twenty in number. The 
large intestine is furnished 
with three arteries called 
colic arteries. The ileo-colic 
artery sends branches to the 
lower part of the ileum, head 
of the colon, and the appendicula vermiformis. The right colic 
artery forms arches, from which branches are distributed to the 
ascending colon. The colica media separates into two branches, 
Fig. 30. 
Villi of the small intestine largely mag- 
nified. 
Fig. 31. 
A section of the Ileum, inverted so as to show 
the appearance and arrangement of the villi on 
an extended surface. 44 
COMMON SENSE MEDICAL ADVISER. 
one of which is sent to the right portion of the transverse colon, 
the other, to the left. In its course, the superior hemorrhoidal 
artery divides into two branches which enter the intestine from 
behind, and embrace it on all sides almost to the anus. 
53. The Thoracic JDuct is the principal trunk of the absorb- 
ent system, and the canal through which much of the chyle 
and lymph are conveyed 
to the blood. It begins by 
a convergence and union 
of the lymphatics on the 
lumbar vertebrae, in front 
of the spinal column, then 
passes upward through the 
diaphragm to the lower part 
of the neck, from thence 
curves forward and down- 
ward, opening into the sub- 
clavian vein near its junc- 
tion with the left jugular 
vein, which leads to the 
heart. 
54. The Liver, which is 
the largest gland in the body, 
weighs about four pounds, in 
the adult, and is located on 
the right side, immediately 
below the diaphragm. It is a 
single organ, of a dark red 
color, its upper surface being 
convex, while the lower is 
concave. It has two large 
lobes, the right being nearly 
four times as large as the 
left. The liver has two coat- 
ings, viz: The serous—which 
is a complete investment, with the exception of the diaphragm- 
atic border, and the depression for the gall-bladder—helps to 
suspend and retain it in position. The fibrous, is the inner coat 
which covers the liver, and forms sheaths for the blood-vessels 
Fig. 32. 
c, c. Right and left subclavian veins. 6. 
Inferior vena cava. a. Intestines, d. En- 
trance of the thoracic duct into the left sub- 
clavian vein. 4. Mesenteric glands through 
which the lacteals pass to their thoracic duct. THE DIGESTIVE ORGANS. 
45 
and excretory ducts. The liver is abundantly supplied with 
arteries, veins, nerves and lymphatics. Unlike the other glands 
of the human body, it 
receives two kinds of 
blood, the arterial for 
its nourishment, and 
the venous, from which 
the bile is secreted. In 
the lower surface of the 
liver is lodged the gall- 
bladder, a membranous 
sac, or reservoir for the 
bile. This fluid is not 
absolutely necessary to 
the digestion of food, 
since this process is 
effected by other secretions, nor does bile exert any special 
action upon starchy or oleaginous substances, when mixed with 
them at a temperature of 100° F. Experiments also show that in 
some animals, there is a constant flow of bile even when no 
food has been taken, and consequently no digestion to be effected. 
Since the bile is formed from the venous blood and taken from 
the waste and disintegration of animal tissue, it would appear 
that it is simply an excrementitious fluid; but it does not seem 
to have accomplished its function when discharged from the 
liver and poured into the intestine, for there it undergoes various 
alterations previous to re-absorption, and these changes seem to 
be of a catalyctic (decomposing and recomposing) nature, pro- 
duced by its contact with the intestinal juices. Thus the bile 
after being transformed in the intestines, re-enters the blood 
under a new form, and is carried to some other part of the system 
to perform its mission. 
55. The Spleen is oval, smooth, convex on its external, and 
irregularly concave on its internal surface. It is situated on 
the left side, in contact with the diaphragm and stomach. It 
is of a dark red color, slightly tinged with blue at its edges. 
Some Physiologists affirm that no organ receives a greater pro- 
portion of blood according to its size, than the spleen. The 
structure of the spleen and that of the mesenteric glands are 
Fig. 33. 
The inferior surface of the liver. 1. Right lobe. 2. 
Reft lobe. 3. Gall-bladder. 46 
COMMON SENSE MEDICAL ADVISER. 
similar, although the former is provided with a scanty supply of 
lymphatic vessels, and the chyle does not pass through it, as 
through the mesenteric glands. The Pancreas lies behind the 
stomach, and extends transversely across the spinal column, to 
the right of the spleen. It is of a pale, pinkish color, and its 
secretion is analogous to 
that of the salivary glands; 
hence, it has been called 
the Abdominal Salivary 
Gland. 
56. Digestion is ef- 
fected in those cavities 
which we have described 
as parts of the alimentary 
canal. The food is first 
received into the mouth 
where it is masticated by 
the teeth, and after being 
mixed with mucous and 
saliva, is reduced to a 
mere pulp; it is then col- 
lected by the tongue, 
which, aided by the vol- 
untary muscles of the 
throat, carries the food 
backward into the phar- 
ynx, and, by the action 
of the involuntary mus- 
cles of the pharynx and 
esophagus, is conveyed to 
the stomach. Here the 
food is subjected to a 
peculiar, churning move- 
ment by the alternate re- 
laxation and contraction 
of the fibres which com- 
pose the muscular wall 
of the stomach. As soon 
as the food comes in 
Fig. 3Jh 
Digestive organs. 3. The tongue. 7. Parotid 
gland. 8. Sublingual gland. 5. Esophagus. 9. 
Stomach. 10. Liver. 11. Gall-bladder. 14. Pan- 
creas. 13, 13. The duodenum. The small and 
large intestines are represented below the stomach. THE DIGESTIVE ORGANS. 
47 
contact with the stomach, its pinkish color changes to a bright 
red, and from the numerous tubes upon its inner surface, is dis- 
charged a colorless fluid called the gastric juice, which mingles 
with the food and dissolves it. When the food is reduced to a 
liquid condition it accumulates in the pyloric portion of the 
stomach. Some distinguished physiologists believe that the food 
is kept in a gentle, unceasing, but peculiar motion, called peri- 
staltic, since the stomach contracts in successive circles. Nor is 
the food in the stomach arranged in an unmethodical manner, 
but the undigested portions are detained in the upper or cardiac 
extremity, near the entrance of the esophagus, by a contraction 
of the circular fibres of the muscular coat. Here it is grad- 
ually dissolved, and carried into the pyloric portion of the 
stomach. From this, then, it appears, that the dissolved and 
undissolved portions of food occupy different parts of the stomach. 
After the food has been dissolved by this gastric acid, it is con- 
verted into a homogeneous, semi-fluid mass called, chyme. This 
substance passes from the stomach through the pyloric orifice 
into the duodenum, where, by mixing with the bile and pancre- 
atic fluid, its chemical properties are again modified. By experi- 
ment, the chyme has been found to be composed of three distinct 
parts,viz: a reddish brown sediment at the bottom, a whey colored 
fluid in the middle, and at the top a creamy film. The creamy 
and whey colored fluids are the constituents of chyle, and the 
sediment is excrementitious. The chyle and excrementitious 
substances are transmitted along the interior of the small intes- 
tine, where the chyle is absorbed by the villi into the lacteal 
tubes. These villi occupy the surface of the small intestine, and 
absorb the creamy and nutritious portions of food, while the 
excrement passes onward to the lower portion of the intestines, 
from thence to be expelled from the system. The lacteals, filled 
with chyle, pass into the mesenteric glands with which they freely 
unite, and afterward enter the receptaculum chyli, which is the 
commencement of the thoracic duct. Here also terminate the 
lymphatics, the functions of which are to secrete and elaborate 
lymph. From this reservoir the chyle and lymph flow into the 
thoracic duct, by which they are conveyed to the left subclavian 
vein, there to be mingled with venous blood. The blood, chyle 
and lymph are then transmitted directly to the lungs. A living 48 
COMMON SENSE MEDICAL ADVISER. 
body is constantly and necessarily subject to vital changes. The 
process of nutrition aids in the development and growth of 
the body; hence it has been aptly designated a “ perpetual 
reproduction.” It is the process by which every part of the body 
assimilates portions of the blood distributed to it. In return 
the tissues yield a portion of the material which was once 
a component of their organization. The body is constantly 
undergoing waste as well as repair. One of the most inter- 
esting facts in regard to the process of nutrition in animals 
and plants is, that all tissues originate in cells. In the higher 
types of animals, the blood is the source of the materials from 
which the cells derive their constituents. Although the ali- 
mentary canal is more or less complicated in different classes of 
animals, yet there is no species, however low in the scale of 
organization, which does not possess it in some form.* The little 
Polyp has only one digestive cavity, which is a pouch in the 
interior of the body. In some animals circulation is not distinct 
from digestion, in others, respiration and digestion are performed 
by the same organs; but as we rise in the scale of animal life, 
digestion and circulation are accomplished in separate cavities, 
while the functions of nutrition become more complex and 
distinct. 
* The males of Cryptophialus and Aloippe, species of marine animals, are apparent 
exceptions to this rule. They are parasitic, possess neither mouth, stomach, thorax 
or abdomen, and are, necessarily, short lived. CHAPTER V. 
PHYSIOLOGICAL ANATOMY. 
ABSORPTION 
57. Absorption is a vital function, by which nutritive mate- 
rials are selected, and imbibed for the sustenance of the body. 
Absorption, like all other functional processes, employs agents to 
effect its purposes, and the villi of the small intestine are espe- 
cially employed, with their 
numberless projecting organs, 
to imbibe fluid substances; 
this they do with a celerity 
commensurate with the im- 
portance and extent of their 
duties. They are little vas- 
cular prominences of the mu- 
cous membrane, arising from 
the interior surface of the 
small intestine. Each villus 
has two sets of vessels, viz: 
(1.) The blood-vessels, which, 
by their frequent blending, 
form a complete network just 
beneath the external epithelium; uniting at the base of the 
villus, they form a minute vein, which is one of the sources 
of the portal vein. (2.) In the centre of the villus is another 
vessel, with thinner and more transparent walls, which is the 
commencement of a lacteal. 
Fig. 35. 
'Villi of the small intestine largely mag- 
nified. 50 
COMMON SENSE MEDICAL ADVISEE. 
58. The Lacteals originate in the walls of the alimentary 
canal, though they are most numerous in the small intestine from 
which they chiefly arise, and passing between the laminae of the 
mesentery, they terminate in the receptaculum chyli. The 
mesentery consists of a double layer of cellular and adipose tissue. 
It incloses and conducts the blood-vessels, lacteals and nerves of 
the small intestine, together with its accessory glands. It is 
joined to the posterior abdominal wall by a narrow origin; ante- 
riorly it is attached to the whole length of the small intestine. 
The lacteals are known as the absorbents of the intestinal walls, 
and after digestion is accomplished, are found to contain the 
white, milky fluid called chyle. The chyle does not represent 
the entire product of digestion; but only the fatty substances 
suspended in a serous fluid. 
59. Formerly, it was supposed that the lacteals were the only 
agents employed in absorption, but more recent investigations 
have shown that the blood-vessels participate equally in the pro- 
cess, and are frequently the more active and important of the 
two. Experiments upon living animals have proved that absorp- 
tion of poisonous substances occurs, even when all communica- 
tion by way of the lacteals and lymphatics is obstructed, the 
passage by the blood-vessels alone remaining. The absorbent 
power, which the blood-vessels of the alimentary canal possess, 
is not limited to alimentary substances, but through them, solu- 
ble matters, of almost every description are received into the 
circulation. 
60. The Lymphatics are not less important factors in the 
process of absorption. Nearly every part of the body is perme- 
ated by a second series of capillaries, closely interlaced with the 
blood-vessels, and collectively termed the Lymphatic System. 
Their origin cannot be clearly traced, but they appear to form a 
plexus in the tissues from which their converging trunks arise. 
They are composed of minute tubes of delicate membrane and 
have a network arrangement. From this network they converge 
into a succession of branches, and finally terminate in two main 
trunks, called the great lymphatic veins. The lymphatics, 
instead of commencing on the intestinal walls, as do the lacteals, 
are distributed through most of the vascular tissues as well as 
the skin. The lymphatic circulation is not unlike that of the ABSORPTION. 
51 
Fig. 86. 
A general view of the Lymphatic System. 52 
COMMON SENSE MEDICAL ADVISER. 
blood; its circulatory apparatus is, however, more delicate, 
and its functions are not so well understood. The lymph which 
circulates through the lymphatics, 
as the blood through the veins, 
is a colorless fluid, and similar in 
its character to the serum. Its 
ingredients, which are derived 
from the material waste arising 
from the transformation of the 
tissues, are taken to the lym- 
phatic glands, and there revivified 
and returned to the general cir- 
culation, wThere they are assimi- 
lated. The function of the 
lymphatics is, then, to absorb 
worn-out materials, re-elaborate 
and prepare them for further use. 
61. In all animals, which pos- 
sess a lacteal, there is also a lym- 
phatic system, the one being a 
complement of the other. The 
fact that lymph and chyle are 
both conveyed into the general 
current of circulation, leads to the inference, that the lymph, as 
well as the chyle, is subservient to the process of nutrition. The 
body is continually undergoing change, and vital action implies 
waste, as well as growth of tissues. Those organs, which are the 
instruments of motion, as the heart, etc., cannot be employed 
without the wear and waste of their component parts. Reno- 
vated and renewed tissues must replace those which are worn- 
out, and it is a part of the function of the absorbents to convey 
the reconstructed, nutritive material into the general circulation. 
The same process which exhales stench, also liberates fragrance. 
The perfumer rejects the one, and secures the other for the re- 
galement of our senses. So the lymphatics cull the valuable 
portions of the separated materials, and submit the debris to 
excretion. The glands are the workmen in the grand laboratory of 
nature where these materials are again economically prepared for 
the use and nourishment of the body. Experiment has shown 
Fig. 37. 
1. A representation of a lymphatic 
vessel highly magnified. 
2. Lymphatic valves. 
3. A lymphatic gland and its vessels. absorption: 
53 
the skin to be a powerful absorbent; for in the lowest species of 
animals, external absorption is as necessary to the maintenance of 
life as the same process, performed internally; and in certain 
conditions of the system, both the cutaneous and pulmonary 
sux’faces absorb with astonishing rapidity. 
62. Absorption is one of the earliest and most essential func- 
tions of animal and vegetable tissues. The simpler plants, con- 
sist of only a few cells, all of which are employed in absorption; 
but in the flowering plants this function is performed by the 
roots. It is accomplished on the same general principles in ani- 
mals, yet it presents more modifications, and involves greater 
complexity than in vegetables. While animals receive their food 
into a sac or bag, called the stomach, and are provided with 
absorbent vessels, such as nowhere exist in vegetables, plants 
plunge their absorbent organs into the earth, whence they derive 
nourishing substances. In the lower order of animals, as sponges, 
this function is performed by contiguous cells, in a manner al- 
most as elementary as in plants. In none of the invertebrate 
animals, is there any special, absorbent system. Internal absorp- 
tion is by some classified as follows: interstitial, recrementitial, 
and excrementitial; other methods are termed accidental, venous, 
and cutaneous. The general cutaneous and mucous surfaces 
exhale, as well as absorb; thus the skin, by means of its su- 
doriferous glands, exhales moisture, and is at the same time a 
powerful absorbent. The mucous surface of the lungs is con- 
tinually throwing off carbonic acid and absorbing oxygen gas; 
and through their surface, poisons are sometimes taken into the 
blood. The continual wear and waste to which living tissues 
are subject, necessitates the provision of such a system of ves- 
sels for conveying away the worn-out, and supplying the body 
with new materials. With absorption as its counterpart, 
nutrition accomplishes this function, and thus economically 
husbands the vital supplies of the body. CHAPTER VI. 
PHYSICAL AND VITAL PROP- 
ERTIES OF THE BLOOD. 
63. Blood is the animal fluid by which the tissues of the body 
are nourished. This pre-eminently vital fluid permeates each 
organ, distributes nutritive material to every texture, is essen- 
tially modified by respiration, and, finally, is the soxirce of every 
secretion. Blood has four constituents, viz: Fibrine, Albumen, 
Salts—these elements, in solution, form the liquor sanguinis— 
and the Corpuscles which are suspended in this solution. Micro- 
scopical examination shows that the corpuscles are of two kinds, 
the red and the white, the former being by far the more abundant. 
They are circular in form and have a smooth exterior. If spread 
out in thin layers and subjected to transmitted light, they 
present a slightly yellowish color, but when crowded together 
and viewed by refracted light, 
exhibit a deep red color. These 
blood corpuscles have been 
termed discs, and are • not, as 
some have supposed, solid ma- 
terial, but are very nearly fluid. 
The red corpuscles, although 
subjected to continual move- 
ment, have a tendency to approx- 
imate to one another, and when 
their flattened surfaces come 
in contact, so firmly do they 
adhere, that they will change 
their shape sooner than submit to a separation. If separated, 
Fig. 88. 
Red Corpuscles of human blood, repre- 
sented at a, as they are seen when rather 
beyond the focus of the microscope; and 
at 6 as they appear when within the focus. 
Magnified 400 diameters. PHYSICAL AND VITAL PROPERTIES OP THE BLOOD. 
however, they will return to their usual form. The white cor- 
puscles are less numerous, similar in size, and have no adhesive, 
but a higher refractive power than the red. They have been 
regarded by some physiologists as identical with those of the 
lymph and chyle. Dr. Carpenter believes, that the function 
of these cells is to convert albumen into fibrine, by the simple 
process of cell-growth. There are various opinions concern- 
ing the manner in which the noil-nucleated, red corpuscles 
of mammalian blood are produced from the colorless or lymph- 
corpuscles. Some physiologists entertain the notion that the 
lymph-corpuscles are transformed into the red corpuscles of 
the blood. Mr. Paget holds to this opinion, and indicates the 
regular process of their development from the lymph, to the fully 
developed red blood-corpuscle. When blood is taken from the 
body and allowed to 
remain at rest, it sep- 
arates into two parts: 
a solid mass called 
the clot, largely com- 
posed of fibrine, and 
a fluid, known as the 
serum in which the 
clot is suspended. 
The process of their 
separation is termed 
coagulation. T h e 
serum, mostly com- 
posed of albumen is 
a transparent, straw- 
colored fluid having 
the odor and taste 
of blood. The whole quantity of blood in the body is estimated 
to be from twenty to twenty-eight pounds. The distinctions be- 
tween the arterial and venous blood are marked, since in the 
arterial system the blood is uniformly red, and in the venous 
of a dark purple color. Oxygen and carbonic acid are both 
present, in solution, in the blood-corpuscles. When carbonic 
acid predominates, the blood is purple; when oxygen, scarlet. 
In the lungs the globules give up the carbonic acid, and 
Fig. 39. 
Development of human lymph, and chyle corpuscles 
into red corpuscles of blood. A. A lymph, or white blood- 
corpuscle. B. The same in process of conversion into a 
red corpuscle. C. A lymph-corpuscle with the cell wall 
raised up around it by the action of water. D. A lymph- 
corpuscle, from which the granules have almost disap- 
peared. E. A lymph-corpuscle, acquiring color; a single, 
granule, like a nucleus, remains. F. A red corpuscle 
fully developed. 56 
COMMON SENSE MEDICAL ADVISER. 
absorb a fresh supply of oxygen, while in the general circulation, 
the oxygen disappears in the process of combustion, and is 
replaced in the venous blood by carbonic acid. The nutritive 
portions of food are converted into a homogeneous fluid, which 
pervades every part of the body, is the basis of every tissue, and, 
by general usage is termed the blood. This varies in color and 
composition in different animals. In the polyp it is known as 
chyme, in many mollusks, as well as articulates, it is called chyle, 
but in vertebrates it is more highly organized and constitutes 
blood. In all the higher animal types it is of a red color, al- 
though redness is not one of its essential qualities. Some tribes 
of animals possess true blood, which is not red. The blood of 
the insect is colorless and transparent, that of the reptile yellow- 
ish, and in the fish the principal part is without color. The blood 
of the bird is deep red, but it is brightest in the mammalia. 
The temperature of the blood varies in different species no 
less than in animals of the same species under different physio- 
logical conditions; for this reason, some animals are called 
cold-blooded. Disease also modifies the temperature of the 
blood, generally increasing it in fevers, but rapidly diminishing it 
in cholera. The blood has been aptly termed the “vital fluid,” 
since there is a constant flow from the heart to the tissues and 
organs of the body, and a continual return after it has circulated 
through these parts. Its presence in every ‘part of the body is 
one of the essential conditions of animal life, and is effected by 
a special set of organs called the circulatory organs. CHAPTER VII. 
PHYSIOLOGICAL ANATOMY. 
CIRCULATORY ORGANS. 
64. Having considered the formation of Chyle, traced it 
through the digestive process, seen its transmittance into the 
vena cava (the vein at the lower part of the neck) and finally its 
conversion into blood, we come to notice how it is distributed 
to every part of the system, through organs, which, from the 
round of duties they perform, are called circulatory. These 
are the Heart, Arteries, Veins and Capillaries, which constitute 
the vascular system. 
65. The Heart is placed obliquely in the left cavity of the 
chest, between the lungs, and has the form of an inverted cone, 
with its base directed upward and backward, toward the right 
shoulder, while its apex points downward to the left side of the 
chest. The heart is a double organ, having a right and left side, 
and its base attached to the posterior walls of the thorax, while 
the apex is free. It is surrounded and held in place by a mem- 
branous sac, called 'pericardium, which,—from its derivation— 
signifies around the heart. It is composed of muscular fibres 
traversing it in different directions. Its weight in the female 
adult is about eight ounces, in the male, ten ounces. The heart is 
divided at its apex into two parts called Ventricles, and at its base 
into the Auricles. The base and apex are separated by internal 
walls. The auricles differ somewhat from the ventricles, theii 
walls are thinner as they serve for the reception of blood; the ven- 
tricular walls are thicker, and therefore more powerful. The left 58 
COMMON SENSE MEDICAL ADVISER. 
ventricle is stronger than the right. I roni the interior parts or the 
ventricles arise 
fleshy columns, 
called columnce 
carnece. Be- 
tween the right 
auricle and ven- 
tricle are three 
valves or folds, 
termed, on ac- 
count of their 
number, tricus- 
pid; while be- 
tween the left 
auricle and ven- 
tricle are two 
valves called the 
mitral, and from 
their free edges, 
are seen small 
cords attached 
to the fleshy col- 
umns to prevent them from being carried into the auricle. The 
cavity of the right side of the heart is triangular in shape, while 
that of the left, is oval. From the right ventricle arises the 
pulmonary artery which proceeds upward to the left side, and 
after a distance of about one inch divides into two branches, 
one of which turns in a curve and enters the right lung, while 
the other passes directly to the left. Each subdivision of the 
pulmonary artery divides into numerous branches, terminating 
in a delicate network within the lungs. The blood, which they 
contain, is then only separated by a thin membrane from the 
contiguous cells and is received into the pulmonary veins. The 
function of the pulmonary artery is to convey venous blood to 
the dungs. The left ventricle gives rise to a very large artery 
called the aorta, which proceeds upward to the right side, then 
arches backward to the left, reversing its direction over the 
main air tube of the left lung, where it passes down in front of 
the spinal column; at the lower part of the abdominal cavity it 
Fig. Jf.0. 
General view of the heart and lungs t. Trachea or windpipe. 
a. Aorta, p. Pulmonary artery. 1, 3. Branches of the pulmon- 
ary artery, one going to the right, the other to the left lung, h. 
The heart. CIRCULATORY ORGANS. 
59 
divides into two arteries, which carry blood to the pelvis and 
lower extremities. 
66. The Arteries. The word 
artery is of Greek derivation, and 
signifies an air tube. The ancients 
did not understand the principle 
of circulation, and finding the 
arteries always empty after death 
supposed them to be tubes con- 
taining air. Arteries are the 
cylindrical tubes which carx-y blood 
to every part of the system. All 
of the arteries arise fi-om the two 
main trunks—the pulmonary artery 
and the aorta. They are of a yel- 
lowish white color, and their inner 
surface is smooth. The arteries 
have three coats, viz: (a.) The ex- 
ternal coat which is destitute of 
fat, and composed chiefly of cellu- 
lar tissue, is veiy firm and elastic 
and can be readily dissected fi’om 
the middle coat, (b.) The middle, 
or fibrous coat, is thicker than the 
external, and composed of yellow- 
ish fibi’es; its chief property is 
that of contractility, (c.) The in- 
ternal coat consists of a colorless, 
thin, transparent membrane, yet 
so strong that it can — it is thought — better resist a powerful 
pi-essure than either of the others. Arteries are very elastic as 
well as extensible, and their chief extensibility is in length. If 
an artery of a dead body be divided, although emptied of its 
contents, its cylindrical form is preserved. Let a finger be placed 
over an artery which lies near the surface, and a sensation will 
be readily experienced at evexy thx-ob; this is called the pulse. 
67. The Veins are the vessels which return the venous blood 
to the auricles of the heart. They ai’e moi’e numerous than the 
arteries, and originate from numerous capillary structures, while 
Fig. Jfl. 
1. The descending vena cava. 2. 
The ascending vena cava. 3. The 
right auricle. 4. The opening between 
the right auricle and the right ventri- 
cle. 5. The right ventricle. 6. The 
tricuspid valves. 7. The pulmonary- 
artery. 8, 8. The branches of the pul- 
monary artery which pass to the right 
and left lung. 9. The semi-lunar valves 
of the pulmonary artery. 10. The 
septum between the two ventricles of 
the heart. 11, 11. The pulmonary 
veins. 12. The left auricle. 13. The 
opening between the left auricle and 
ventricle, lh. The left ventricle. 15. 
The mitral valves. 16,16. The aorta. 
17. The semi-lunar valves of the aorta. 60 
COMMON SENSE MEDICAL ADVISEE. 
the arteries usually begin from one main trunk. In some parts 
of the body, the veins correspond in number to the arteries, 
while in others, there 
are two veins to every 
artery. The veins 
commence by minute 
roots in the capilla- 
ries, which are every - 
where distributed 
through the body, and 
gradually increase in 
size, until they unite 
and become large 
trunks conveying the 
dark blood to the 
heart. The veins have 
also three coats. The 
external or cellular 
coat resembles that of 
the arteries. The mid- 
dle, is fibrous, but thin- 
ner than the corres- 
ponding one of the 
arteries, while the in- 
ternal coat is serous, 
and analogous to that 
of the arteries. The 
veins belong to three 
classes, viz: (1.) The systemic veins bring the blood from 
dilferent parts of the body and discharge it into the vena 
cava by means of which it is conveyed to the heart. (2.) The 
pulmonary veins bring the arterial or red blood from the lungs 
and carry it to the left auricle. (3.) The veins of the portal 
system originate from capillary beginnings in the abdominal 
organs, then converge into trunks and enter the liver to branch 
off again into divisions and subdivisions of the minutest character. 
68. The Capillaries form an extremely fine network and are 
distributed to every part of the body. They are so univer- 
sally prevalent throughout the skin, that the puncture of a 
Fig. J$. 
A representation of the venous and arterial circula- 
tion of the blood. CIRCULATORY ORGANS. 
61 
needle would wound several of them. They may be called the 
true workmen of the human system, for they are in reality the 
builders of it. These vessels receive the blood and take from it 
the particles necessary for the renewal of the body, after which 
it is transmitted through the veins surcharged with carbon, 
and carried to the lungs. 
69. The blood in its course passes from the right auricle into 
the right ventricle, and is prevented from reflowing by the 
tricuspid valves, from thence it passes through the pulmonary 
artery to the lungs and its return into the ventricle is ob- 
structed by the semi-lunar valves. Here the blood is changed 
from a bluish to a scarlet color;, it is then returned to the left 
auricle of the heart through the pulmonary veins. The left 
auricle by its contraction, forces the blood into the left ventricle, 
and the mitral valves prevent its reflowing. From the left ven- 
tricle the blood is forced into the aorta, by which it is distributed 
to every part of the system. The semi-lunar valves prevent its 
return. It is estimated that from three to eight minutes are 
required for the blood to traverse its rounds through the body 
and return to the heart. The quantity of blood varies in differ- 
ent individuals; there are from twenty to twenty-eight pounds 
in the healthy adult. 
70. No language can adequately describe the beauty of the 
circulatory system. The constant vital flow through the larger 
vessels, and the incessent activity of those so minute that they 
are almost imperceptible, fully illustrate it. By a mere blush, 
myriads of invisible blood-vessels spring into view; again they 
assume various shapes, and blending lines, now reflecting upon 
themselves they become mere incipient veins, again altering their 
course, they reveal themselves as branches sent off from an artery. 
Sometimes they are contracted and again dilated; at times the 
flow of blood is quickened, at others, it is sluggish, if not alto- 
gether retarded. It is by pulse beats and heart throbs that life 
is measured. CHAPTER VIII. 
PHYSIOLOGICAL ANATOMY. 
THE ORGANS OF RESPIRATION. 
71. The Organs of Respiration are the Trachea, 
(windpipe), Bronchia (subdivisions of the trachea), Air cells, 
and Lungs. The Trachea is a vertical tube situated between the 
lungs below, and a short quadrangular cavity above, called the 
Larynx, which is a part of the windpipe, and used for the pur- 
pose of modulating the voice in reading or singing. In the 
adult, the trachea — in its unextended state — is from four and 
one-half, to five inches in length, about one inch in diameter, 
and, like the larynx, is more fully developed in the male than in 
the female. Its structure is of a fibro-cartilaginous character, 
and is composed of flattened rings, or segments of circles. It 
freely permits the passage of air to and from the lungs. 
72. The Lronchia are two tubes or branches proceeding froni 
the division of the windpipe to either lung. Upon entering the 
lungs, they divide and subdivide until, finally, they terminate in 
small cells called the bronchial or air cells, which are of a 
membranous character. 
73. The Lungs are conical organs, situated within the chest, 
filling the greater part of it, since the heart is the only other 
organ which occupies much space in the cavity. The lungs 
are convex externally, and conform to the thoracic cavity, while 
the internal surface is concave for the reception of the heart. 
The size of the lungs depends upon the capacity of the chest. 
Their color varies, being of a pinkish hue in childhood, but THE ORGANS OP RESPIRATION. 
63 
of a gray, mottled appearance, in the adult. They are divided 
into the right, 
and left lung. 
Each lung re- 
sembles a cone 
with its base 
resting upon the 
diaphragm, and 
its apex, behind 
the collar bone. 
The right lung 
is larger, though 
shorter, than 
the left, and 
has three lobes, 
formed by deep 
fissures, or lon- 
gitudinal divi- 
sions, the 
left, has but two 
lobes. Each 
lung has also 
lobules (small 
lobes) connected 
by cellular tis- 
sue, and these, in turn, are divided into air cells. The lungs are 
freely supplied with blood vessels, lymphatics and nerves. The 
density of a lung depends upon the amount of air it contains. 
Thus, experiment has shown that in a foetus which has never 
breathed, the lungs are compact, and will sink in water; but as 
soon as they become inflated with air, they spread over a larger 
surface and are therefore more buoyant. Each lung is invested, 
as far as its root, with a membrane called the pleura. It is then 
continuously extended to the cavity of the chest, thus perform- 
ing the double office of lining it, and constituting a partition be- 
tween the lungs, which is termed the mediastinum. When this 
membrane is inflamed, the disease is called “pleurisy.” The 
lungs are kept in position by the root, which is formed by the 
pulmonary veins, nerves and bronchial tubes. Respiration is the 
Fig. JfS. 
An ideal representation of the respiratory organs. 3. The 
larynx. 4. The trachea. 5, 6. The bronchia. 9, 9, 9, 9. Air- 
cells. 1,1,1, 2, 2, 2. Outlines of the lungs. COMMON SENSE MEDICAL ADVISEE. 
twofold function of inspiration (taking air into the lungs) and 
expiration (expelling air 
from the lungs). The 
object of respiration is 
to eliminate carbonic 
acid from the blood, to 
supply its place with 
oxygen, and to assist 
in converting the chyle 
into blood. The act of 
expiration consists chief- 
ly in the elevation of 
the diaphragm and de- 
scent of the ribs, while 
inspiration is principally 
effected by the descent 
of the diaphragm and 
elevation of the ribs. 
74. When the mus- 
cles of some portions of 
the air-passages are .relaxed, a peculiar vibration follows known 
as “ snoring.” Coughing and sneezing are sudden and spasmodic, 
though generally involuntary acts. Sighing is a prolonged, deep 
inspiration, followed by a rapid and generally audible expiration. 
It is remarkable that laughing and sobbing, although indicative 
of opposite states of the mind, are produced by very nearly the 
same mechanical agencies. In hiccough, contraction is more 
sudden and spasmodic than in laughing or sobbing. In sleeping, 
the quantity of oxygen consumed is estimated to be considerably 
less than during wakefulness. 
75. It is difficult to estimate the amount of air taken into 
the lungs at each inspiration, as the quantity varies, in different 
individuals, according to condition, size and expansion of the 
chest. The consumption of oxygen is greater when the temper- 
ature is low and during digestion. All of the respiratory 
movements — so far as they are independent of the consciousness 
of the individual — are controlled by that part of the brain, 
called the medulla-oblongata. This respiratory, or breathing 
process, is not instituted for the benefit of man alone, for we find 
Fig. U- 
A representation of the heart and lungs, k. The 
heart. 5. The pulmonary artery. 8. Aorta. 11, 9. 
Upper lobes of the lungs. 10,13. Lower lobes. 12. 
Middle lobe of the right lung. g. Superior vena cava. 
8. Inferior't'ena cava. THE ORGANS OP RESPIRATION. 
65 
it both in the lower order of animals, and in plant life. Nature 
is very economical in the arrangement of her plans, since what 
is useless to man is made indispensable to the existence of plants, 
and the oxygen rejected by them, is appropriated to his use. 
In the lower order of animals the respiratory act is similar to 
that of the higher types, though not as complex; for there are no 
organs of circulation, nor ventilation,-—as the lungs and gills 
are called. Thus, the higher the animal type the more complex 
its organization. The effect of air upon the color of blood is 
very noticeable. For, if it be drawn from the body, although 
at first presenting a dark appearance, when coming in contact with 
the air, it gradually changes its color to a brighter hue. There 
is a marked difference between the properties of the venous and 
the arterial blood. 
76. The ve- 
nous blood is 
carried to the 
right side of the 
heart and lungs, 
and finally re- 
turned to the 
left side, where 
it is converted 
into arterial 
blood. It is now 
of uniform char- 
acter, ready to 
b e distributed 
throughout the 
body, and capa- 
ble of sustain- 
ing and nourish- 
ing life. Man 
breathes by 
means of lungs. But who can understand this wonderful me- 
chanism, so perfect in all its parts ? While every organ is sub- 
servient to an other, yet each has its own office to perform. The 
minute air vesicles are for the aeration of the blood; the larger 
bronchial tubes ramify the lungs, and suffuse them with air; the 
Fig. Jf5. 
View of the Pulmonary circulation. COMMON SENSE MEDICAL ADVISEE. 
trachea serves as a passage for the air to, and from the lungs, 
while at its upper extremity is the larynx, which has been fitly 
called the organ of the human voice, since it is the most com- 
plete of all musical instruments. At its extremity we find a sort 
of shield called the epiglottis, the office of which is to guard this 
delicate instrument, and prevent foreign bodies from obstructing 
the passage. CHAPTER IX. 
PHYSIOLOGICAL ANATOMY. 
THE SKIN. 
77. The digestive process is continually supplying the blood 
with material for its renewal. While the nutritive constituents 
of the blood are retained to promote the growth of the body, 
those which are useless, or injurious, are iq, various ways ex- 
pelled, and there is, perhaps, no part of the body more actively 
concerned in their removal than the skin. 
78. The skin is a 
membranous envelope 
investing the whole body. 
It consists of two lay- 
ers, viz: the Cutis vera 
(true skin) and the Cuti- 
cle (epidermis). The 
true shin is composed of 
fibres similar to those of 
the cellular tissue. It 
consists of white and 
yellow fibres which are 
more densely woven near 
the surface than at the 
center; the white gives 
strength, the yellow, 
strength and elasticity 
combined. While the true skin can properly be said to consist 
Fig. Jf6. 
An ideal view of the papillae. 1, 1. Cutis vera. 
2, S. Papillary layer. 3, 3. Arteries of the papillae. 
4, 4. Nerves of the papilla}. 5,5. Veins of the pa- 
pillae. 68 
COMMON SENSE MEDICAL ADVISEE. 
of but one layer, yet it has two surfaces, an external and 
internal, differing in their appearance and characteristics. Upon 
the external surface are little conical prominences, known as 
papillae. The papillae are irregularly distributed over the body, 
in some parts being smaller and more numerous than in others, 
as on the finger-ends, where their summits are so intimately con- 
nected as to form a tolerably smooth surface. It is owing to 
their perfect development that the finger-tips are adapted to 
receive the finest impressions of touch. Although every part of 
the skin is sensitive, yet the papillae are extremely so, for they 
are the principal means through which the impressions of objects 
are communicated. Each papilla not only has a minute vein, 
artery and nerve, but it also incloses loops of tactile nerves 
accompanied with blood-vessels. When the body is exposed to 
the cold, these papillae can be more distinctly seen in the form 
of prominences known as “ goose pimples.” 
79. The internal surface of the skin termed the Corium, con- 
sists of numerous depressions, each of which furnishes a receptacle 
for fat. While the skin 
is supplied with a com- 
plete network of arter- 
ies, veins and nerves, 
which make the skin 
sensitive to the slight- 
est touch, it also teems 
with lymphatic vessels 
so minute that they are 
invisible to the naked 
eye. 
80. Among the 
agents adapted for ex- 
pelling the excretions 
from the system, none 
surpass the Sudorifer- 
ous Glands. These are tortuous organs, which wind in and 
out, over the whole extent of the cutis vera, and secrete the 
perspiration. Though much of it passes off as insensible trans- 
piration, yet it often accumulates in drops of sweat,—the result 
of exercise, or of a high atmospheric temperature. The office 
Firj. Jft. 
A section of the skin, showing its arteries and 
veins. A, A. Arterial branches. B, B. Capillaries 
in which the branches terminate. C. The venous 
trunk into which the blood from the capillaries flows. THE SKIN. 
69 
of the perspiration is two-fold; it removes certain noxious mat- 
ters, radiates the heat, thereby equal- 
izing the temperature of the body. 
This perspiratory secretion renders 
the skin soft and pliable, and thus 
better adapts it to the movements 
of the parts which it covers. The 
Sebaceous (oil glands) which are 
placed in the true skin, are less 
abundant where the sweat glands 
are most numerous, and vice versa. 
Here, as elsewhere, nature acts with 
systematic and accordant design in 
thus distributing these glands where 
they are most needed,—in the eyelids, 
serving as lubricators, in the ear pas- 
sage, to produce the cerumen or wax 
preventing the intrusion of small 
insects, and in the scalp, to supply 
the hair with its own pomatum. 
81. The Cuticle or Epidermis, 
(so called because it signifies placed 
upon the skin) is the outer layer of 
the skin. Since it is entirely desti- 
tute of nerves and blood-vessels, it is 
insensible. Like the cutis vera, this 
has two surfaces composed of layers. 
The internal or Rete Mucosum, which 
is made up chiefly of pigment cells, 
is adapted to the irregularities of the 
cutis vera, and sends prolongations 
into all of its glandular follicles. 
The external surface, or epidermis 
proper, is elastic, destitute of coloring 
matter, and consists of mere horny 
scales. As soon as dry, they are re- 
moved from the exterior in the form of scurf, and replaced by 
new ones from the interior or cutis vera. These scales are also 
freely removed by the wet sheet-pack, or by friction. The 
Fig. Jf8. 
A perspiratory gland, highly mag- 
nified. 1,1. The gland. 2, 2. Ex- 
cretory ducts uniting to form a tube 
which tortuously perforates the 
cuticle at S, and opens obliquely on 
its surface at 4. 70 
COMMON SENSE MEDICAL ADVISEE. 
cuticle is thus constantly undergoing renewal and change. The 
epidermis serves to cov- 
er and protect the sensi- 
tive parts beneath, for, 
were the nervous tissue 
of the true skin not 
thus protected, every 
contact with external 
bodies would be pain- 
ful. We may here 
observe that the epi- 
dermis contains the 
pigment for coloring 
the skin. In dark com- 
plexioned races—as for 
example, the negro— 
the cuticle is very thick and tilled with black pigment. The 
radiation of animal heat is dependent upon the thickness and 
color of this cuticle. Thus, in the dark races, the pigment cells 
most abound, and in 
proportion as the 
skin is dark or fair, 
do we find these 
cells in greater or 
less abundance. The 
skin of the Albino is 
of pearly whiteness, 
devoid even of the 
pink or brown tint 
—which the Euro- 
pean always has, be 
he ever so fair. This 
peculiarity must be 
attributed to the ab- 
sence of pigment 
cells, which, when 
present, always give a more or less dark color. That climate 
alone is capable of producing all these diversities is simply 
absurd. For those negroes who live in Van Diemen’s Land"— 
Fig. Jf9. 
A representation of oil-tubes from the scalp and 
nose. 
Fig. 50. 
Anatomy of the skin. 5, 5. Cutis vera (true skin). 4, 4. 
Nervous tissue. 3, 3. Sensitive layer in which are seen 
the nerves, z, 3. The layer containing pigment cells. 1,1. 
Epidermis (cuticle). THE SKIN". 
71 
a cold climate—are among the "blackest people on earth. Hum- 
bolt remarks that the American tribes of the tropical regions 
have no darker skin than the mountaineers of the temperate zone. 
Climate may modify, but does not make the complexion. 
82. The hair is an appendage of the skin. It is inclosed in 
a delicate sheath or follicle. The visible part is called the shaft, 
and consists of fibres, surrounded by ap envelope called the 
Fig. 51, 
Structure of Human Hair; A. external surface of the shaft, showing the trans- 
verse stri® and jagged boundary, caused by the imbrications of the scaly cortex; if. 
longitudinal section of the shaft, showing the fibrous character of the medullary 
substance, and the arrangement of the pigmentary matter; C. transverse sections, 
showing the distinction between the corticle and medullary substance, and the cen- 
tral collection of pigmentary matter, sometimes found in the latter. Magnified 310 
diameters. 
cortex. It is formed in the follicle from a layer of cells which 
surround and constitute the fibrous tissue of the shaft. The hair 
grows from this follicle, and its color is chiefly due to the 
pigment cells. The chemical properties of hair are similar to 
those of horn and nails. It can be dissolved in water at a very 
high temperature, and liberates a large quantity of oil mixed 
with sulphuret of iron and sulphuretted hydrogen. This oil 
combined with sulphuret of iron imparts color to the hair, and 
its absence is indicated by grayness. For this reason, sulphur is 
used in the various dyes for renewing the color of gray hair. 
Hair contains a small quantity of water, and, when burned, yields 
a large proportion of iron, manganese, and salts of iron. Owing 
to its composition it is indestructible and has been found per- 
fectly preserved on mummies buried more than twenty centuries. 
Hairs are extremely tough and firm. They vary in size and color. 72 
COMMON SENSE MEDICAL ADVISER. 
The whole body, with the exception of the palms of the hand 
and soles of the feet, is covered with a delicate down, of limited 
growth. The hair of the scalp, however, often grows to a great 
length. It has been supposed that it would grow after death, but 
this is probably owing to the lengthening of the hair by the 
absorption of moisture from the body or atmosphere. 
83. There is another class of appendages connected with the 
skin. These are the finger, and toe-nails, consisting of thin plates 
of horny tissue having a root, body, and free extremity. The 
root as well as the lateral portion, is lodged in the skin, and has 
a thin margin which is received into the groove of the true skin. 
The under surface is furrowed, while the upper is comparatively 
smooth. The nails grow in the same manner as the cuticle. The 
mucous membrane,—a continuation of the skin,—is treated of 
in another chapter of this work. CHAPTER X. 
PHYSIOLOGICAL ANATOMY. 
SECRETION. 
84. The terra Secretion, in its broadest signification, is applied 
to that process by which substances are separated from the blood, 
either for the reparation of the tissues or excretion. In the 
animal kingdom the process is less complicated than in vegetable 
life. In the former, it is really a separation of the nutritive 
materials from the blood. The process, wfien effectuated for the 
removal of effete matter, is, in a measure, chemical and therefore 
the change is greater. 
85. Three elementary constituents are observed in secretory 
organs, viz: (1), cells, (2), a basement membrane, and (3), 
blood-vessels. Obviously, the essential part is the cell. 
8G. Three physical conditions are necessary for a healthful 
action of the secretory organs. (1.) A copious supply of blood. 
(2.) The materials of the blood should be nutritive and abundant. 
(3.) The nervous system also influences the process of secretion 
to a great extent. Intense emotion will produce tears and the 
sight of some favorite fruit will increase the flow of saliva. 
87. The process of secretion depends upon the anatomical 
and chemical constitution of the cell-tissues. The principal 
secretions are (1), Perspiration; (2), Tears; (3), Sebaceous mat- 
ter; (4), Mucus; (5), Saliva; (6), Gastric juice; (7), Milk; (8), 
Intestinal juice; (9), Pancreatic juice; (10), Bile. 
88. Perspiration is a watery fluid secreted in minute 
glands, which are situated in every part of the skin, but more 74 
COMMON SENSE MEDICAL ADVISER. 
numerous on the anterior surfaces. Filiform tubes, only of 
an inch in diameter, and lined with epithelium, penetrate the 
skin, and terminate in rounded coils, enveloped by a network of 
capillaries, which supply the secretory glands with blood. Ac- 
cording to Krauss, the entire number of perspiratory glands can 
not be less than two million three hundred thousand, and the 
length of each glandular coil being T'7 of an inch, we may 
estimate the length of tubing to be not less than two miles and 
a half. This secretion has a sp. gr. of 1003.5 and according 
to Dr. Dalton is composed of 
Water, . 995.50 
Chloride of Sodium, 2.23 
Chloride of Potassium, 0.24 
Sulphate of Soda and Potassa, 0.01 
Salts of organic acids with Soda and Potassa, . 2.02 
1000.00 
Traces of organic matter mingled with a free volatile acid, are 
also found in the perspiration. It is the acid which imparts to 
the secretion its peculiar odor, and acid reaction. The process 
of its secretion is continuous, but, like all bodily functions, it 
may be subjected to influences which will augment or retard its 
activity. If, in a state of repose, evaporation prevents its ap- 
pearance in the liquid form, it has received the name of invisible 
transpiration. If there be unusal muscular activity, it collects 
upon the skin, and is termed sensible perspiration. This secre- 
tion performs an important office in the animal economy, by 
maintaining the internal temperature at 100° F. Even in the 
Arctic. regions where the explorer has to adapt himself to a 
temperature of—40° the generation of heat in the body prevents 
the internal temperature from falling below this standard. On the 
contrary, if the circulation be quickened by muscular exertion, 
the warmer blood flowing from the internal organs into the 
capillaries, raises the temperature of the skin, secretion is aug- 
mented, the moisture exudes from the pores, and evaporation 
begins. A large portion of the animal heat is absorbed in this 
process, and the temperature of the skin is reduced. A very 
warm, dry atmosphere can be borne with impunity, but on the 
introduction of moisture, evaporation ceases, and the life of the 
animal is endangered. Three conditions may be assigned as SECRETION. 
75 
effective causes in retarding or augmenting this cutaneous secre- 
tion;—-(1), a variation in the temperature of the atmosphere, (2), 
muscular activity and (3), nervous states. The emotions exert 
a remarkable influence over the action of the perspiratory glands. 
Intense fear will cause great drops of perspiration to accumulate 
on the skin, while the salivary glands will remain inactive. 
89. Tears. The laclnymal glands are small lobular organs, 
situated at the outer and upper orbit of the eye, and open by 
from eight to twelve ducts upon the conjunctiva, between the 
eyelid and its inner fold. This secretion is an alkaline, watery 
fluid. According to Dr. Dalton, its composition is as follows: 
Water, 982.0 
Albuminous matter, 5.0 
Chloride of Sodium, 13.0 
Mineral Sals, .2 
1000.2 
The office of this secretion is to preserve the brilliancy of the 
eye. The tears are spread over this organ by the reflex move- 
ment of the eyelid, called “ winking,” and then collected in the 
puncta lachrymcilia and discharged into the nasal passage. This 
process is constant during life. The effect of its repression is 
seen in the dimmed appearance of the eye after death. The 
emotion of grief, or, excessive laughtei’, will excite these glands 
until they overflow the lachrymal ducts. 
90. Sebaceous Matter. Three modifications of this 
secretion are found in the body. (1.) A product of the sebaceous 
glands of the skin, is found in those parts of the body which are 
covered with hairs, also on the face and the external surface of 
the organs of generation. The sebaceous glands consist of a 
group of flask-shaped cavities opening into a common excretory 
duct. Their secretion serves to lubricate the hair and soften 
the skin. (2.) The ceruminous glands of the external auditory 
meatus are long tubes terminating in a glandular coil, within 
which is secreted the glutinous matter of the ear. This secre- 
tion serves the double purpose of moistening the outer surface 
of the membrana tympani, and, by its strong odor, preventing 
the intrusion of insects. (3.) The meibomian glands are arranged 
in racemous form along the excretory duct which opens just 
behind the roots of the eyelashes. The oily nature of this 76 
COMMON SENSE MEDICAL ADVISER. 
secretion prevents the tears (when not stimulated by emotion) 
from overflowing the lachrymal canals. 
91. MUCUS. The mucous membranes are provided with 
minute glands which secrete a viscid, gelatinous matter, called 
mucus. The peculiar animal matter which it contains is termed 
mucosine. These gland ulus are most numerous in the Pharynx, 
Esophagus, Trachea, Bronchia, Vagina and Urethra. They con- 
sist of a group of secreting sacs, terminating at one side in a 
closed tube, while the other opens into a common duct. The 
mucus varies in composition in different parts of the body; but 
in all, it contains a small portion of insoluble animal matter. 
Its functions are threefold. It lubricates the membranes, pre- 
vents their injury and facilitates the passage of food through the 
alimentary canal. 
92. Saliva. This term is given to the first of the digestive 
fluids, which is secreted in the buccal glands. It is a viscid, 
alkaline liquid (sp. gr. 1005). If allowed to stand, a whitish 
precipitate will be observed. Examinations with the microscope 
show it to be composed of minute, granular cells and oil globules, 
mingled with numerous scales of epithelium. According to 
Bidder and Schmidt, the composition of saliva is as follows: 
Water, 995.16 
Organic matter, 1.34 
Sulpho-cynide of Potassium, 0.06 
Phosphates of Soda, Lime and Magnesia, . . .98 
Chlorides of Sodium and Potassium, . . . .84 
Mixture of Epithelium, 1.62 
1000.00 
Two kinds of organic matter are present in the saliva; one, 
termed ptyaline, imparts to the saliva its viscidity, and is obtained 
from the secretions of the submaxillary and sublingual glands; 
another, which is not glutinous, is distinguished by the property 
of coagulating when subjected to heat. The saliva is composed 
of four elementary secretions, derived respectively, from the 
mucous follicles of the mouth and the parotid, submaxillary, and 
sublingual glands. The process of its secretion is constant but 
is greatly augmented by the contact of food with the lining 
membrane. The saliva serves to moisten the triturated food, 
facilitate its passage, and has the property of converting starch SECEETIOX. 
77 
into sugar; but the latter quality is counteracted by the action 
of the gastric juice in the stomach. 
93. twa§tric juice. The tubules or follicles situated in 
the mucous membrane of the stomach secrete a clear, colorless, 
acrid liquid, termed the gastric juice. According to Lehmann 
and Schmidt, its composition is as follows: 
Water, 975.00 
Organic matter, 15.00 
Lactic acid, 4.78 
Chloride of Sodium, 1.70 
Chloride of Potassium, 1.08 
Chloride of Calcium, 0.20 
Chloride of Ammonium, 0.65 
Phosphate of Lime, 1.48 
Phosphate of Magnesia, 0.06 
Phosphate of Iron, 0.05 
1000.00 
The presence of the organic matter (pepsine) occasions the 
phenomena designated as catalysis or catalytic transformation. 
The organic matter induces, without decomposition, the chemical 
change of starch into sugar; and the “entire process of nutrition, 
so far as the organic matters are concerned, consists of these 
catalytic transformations.” The lactic acid is the most important 
constituent of the gastric juice, and imparts to this secretion its 
physiological properties. By the peristaltic movement of the 
stomach, the food is mingled with the gastric juice which acts 
as a decomposing agent. The secretion of the gastric juice is 
influenced by nervous conditions. Excess of joy or grief will 
effectually retard or even arrest its flow. 
94. Mill*. The milk is a white, opaque fluid, secreted in 
the lacteal glands of the female mammalia. These glands consist 
of numerous follicles, grouped around an excretory duct, which 
unites with similar ducts coming from other lobules. By succes- 
ive unions they form large branches, termed the lactiferous ducts, 
which open by eighteen or twenty minute orifices on the extremity 
of the mamillse. The most important constituent of milk is ca- 
serne’ it also contains oily and saccharine substances. This secre- 
tion, more than any other, is influenced by nervous conditions. 
A mother’s bosom will fill with milk at the thought of her infant 78 
COMMON SENSE MEDICAL ADVISER. 
child. Milk is ofttimes poisoned by a fit of ill-temper, and the 
infant thrown into convulsions, which in some instances prove 
fatal. 
95. Intestinal jflice. Upon leaving the stomach, that 
portion of the food (the starchy matter) which has not under- 
gone catalytic transformation, passes into the third division of 
the alimentary canal, termed the small intestine. In this organ 
the starch is converted into sugar by the action of the intestinal 
juice — a product of two classes of glands, situated in the mucous 
membrane.—Theseglandulse are termed, respectively, “folliclesof 
Lieberkuhn” and the “glands of Brunner.” The former consist 
of simple tubules, lined with epithelium and are far more numer- 
ous than the glands. The latter are clusters of rounded follicles, 
opening into a common excretory duct. The sacs are composed 
of delicate, membranous tissue, and have numerous nuclei on 
their walls. The difficulty of obtaining the intestinal juice for 
experiment is obvious, and for this reason, its constitution is not 
known. Physically, it resembles the secretion of the mucous 
follicles of the mouth, being colorless and vitreous in appearance, 
and having an alkaline nature. 
96. Pancreatic juice. The oily portion of the food 
now remains to he transformed. Immediately after entering the 
intestine, it is converted into a white, opaque emulsion termed 
chyle. This transformation is accomplished by the action of the 
pancreatic juice,— a colorless fluid, secreted in a lobular gland 
which is situated behind the stomach, and runs transversely from 
the spleen across the vertebral column to the duodenum. The 
most important constituent of the pancreatic juice is the organic 
matter, termed pancreatine. This secretion performs the last 
office in the process of digestion, viz: emulsion. 
97. We may recapitulate the phenomena of digestion in a 
few words. The food is introduced into the mouth, triturated, 
and mingled with the saliva. In the stomach the gastric juice 
changes, by catalytic transformation, all the ingredients except 
the starch and oil. In the small intestine the starch is converted 
into sugar, and lastly the oily matter is transformed into chyle. 
98. The Mile. The liver is very.peculiar in its anatomical 
structure, and is supplied with venous blood. After circulating 
through the organs of the chest and abdomen, the blood is SECRETION'. 
79 
collected by the veins, and discharged into the portal vein which 
conveys it to, and through the liver. The portal vein divides 
and subdivides into branches the smallest of which are only T1J-Vo 
of an inch in diameter (Kolliker). These branches include penta- 
gonal and hexagonal spaces. The hepatic substance contained 
within the terminations of the 
portal vein are termed the 
“acini” of the liver. Each 
acinus is composed of minute 
cellular bodies known as the 
hepatic cells. In these cells the 
blood is deprived of certain 
nutritive materials which are 
converted into bile. This se- 
cretion is a glutinous fluid, 
varying in color from a dark 
golden brown to a bright yel- 
low, and a sp. gr. ranging from 
1018 to 1036. If agitated, it 
has a frothy appearance. Physi- 
ologists have experienced much 
difficulty in studying the char- 
acter of this secretion from the instability of the biliary ingre- 
dients, when subjected to chemical manipulations. 
99. Biliverdine is an organic substance peculiar to the 
bile, and imparts to that secretion its color. When this constit- 
uent is re-absorbed by the blood and circulates through the 
bodily tissues, the skin assumes a bright yellow hue,—the un- 
failing symptom of jaundice. CAolesterine is an inflamable, 
crystallizable substance, destitute of nitrogen and soluble in 
alcohol or ether. It is present in the spleen and all the nervous 
tissues. It is highly probable that it exists in the blood, in some 
state or combination, and assumes a crystalline form only when 
acted upon by other substances or elements. Two other constit- 
uents, more important than either, mentioned above, are collec- 
tively termed “ biliary salts ” These ingredients were discovered 
in 1848, by Strecker, who termed them glyko-cholate and taura- 
cholate of soda. Both are crystalline, resinous substances, and 
although resembling each other in many respects, the chemist 
Fig. 52. 
Section of the Liver, showing the rami- 
fications of the portal vein. 1. Twig of 
portal vein. 2, 2,’ 2," 2.”’ Interlobular 
vein. 3, 3,’ 3.” Acini. 80 
COMMON SENSE MEDICAL ADVISEE. 
may distinguish them "by their reaction; for "both will yield a 
precipitate if treated with subacetate, but only the glyko-cholate 
will give a precipitate with acetate of lead. In testing for 
biliary substances, the most satisfactory method is the one pro- 
posed by Peter- Kofer. A solution of cane-sugar (one part of 
sugar to four parts of water) is mixed with the suspected sub- 
stances. Dilute sulphuric acid is then added until a white 
precipitate falls, which is redissolved in excess of the acid. Con- 
tinue to add the sulphuric acid and it becomes opalescent, and 
passes through the successive hues of scarlet, lake and a rich 
purple. The bile does not aid in the process of digestion. Care- 
ful experiments have proved that it is a constant secretion; but 
its flow is most abundant after the food is introduced into the 
stomach, probably owing to the fact that the are then 
more active in their absorption. During its passage through the 
intestines it disappears. It is not eliminated and Kofer’s test 
has failed to detect its existence in the portal vein. These facts 
lead physiologists to the conclusion, that it undergoes some 
change of a catalytic nature in the intestines, is absorbed, 
circulated through the tissues, ever completing the same circle 
of functions. CHAPTER XI. 
PHYSIOLOGICAL ANATOMY 
EXCRETION. 
100. Under Secretion we noticed only those substances which 
are xiseful in the animal economy. There are substances which 
having lost their vitality, are no longer available for the nutri- 
tion of the bodily tissues. They are readily distinguished from 
the vital constituents and are termed excrementitious. The 
greater part of them contain a large proportion of nitrogen, 
and are soluble in water. They are produced in the tissues, 
absorbed by the blood, and conveyed to the excretory organs, 
by which they are eliminated from the body. That the process 
of excretion is necessary to the continuance of life, is proved 
by the fatality of its suppression. The principal excremen- 
titious substances, are the constituents of urine and carbonic 
acid. The urine is an amber colored fluid, having a peculiar 
odor, and a sp. gr. of 1024. The excretory organs are the Sid- 
neys. They do not secrete, but only solve and prepare for 
excretion. The principal constituents of urine are Urea, Creatine, 
Creatinine, and the Urates of soda, potassa and ammonia. Of 
these, the first is a crystallizable substance, soluble in water and 
contains nitrogen. In its natural state, it is instable if exposed 
to external influences, and exists in the urine in a proportion of 
about thirty parts to a thousand. That the production of urea is 
influenced by muscular activity, was experimentally proved by 
Prof. A. Flint. E. P. Weston, the noted pedestrian, was the 82 
COMMON SENSE MEDICAL ADVISEPv. 
subject, and the conclusion might be interesting to the reader. 
The following table gives the most important results: 
DAILY QUANTITY OF 
1st Period, 
live days 
before walk. 
2d Period, 
five days 
dnri’g walk. 
3d Period, 
five days 
after walk. 
Urea, 
628.24 
722.16 
726.79 
Nitrogen in food, .... 
339.46 
234.76 
440.93 
Nitrogen in urea, .... 
293.15 
337.01 
339.17 
Total nitrogen in urea and feces, 
315.09 
361.52 
373.15 
Nitrogen in urea and feces per 100 
parts of nitrogen in food, 
95.53 
174.81 
91.93 
During the period previous to the walk, the exercise was eight 
miles each day; in the second period, it was an average distance 
of sixty-four miles; and only two miles per day in the last period. 
In the second period, there was a loss of three and one-half 
pounds in weight, which was regained in the five subsequent days. 
Prof. Flint attributed this loss of weight to the icaste of muscu- 
lar tissue, and its replacement to the retention of nitrogenous 
substances. 
101. Creatine and creatinine are crystallizable substances, 
soluble in water and spirits. They are found in the muscles, 
blood and urine. The first originates in the muscles, is absorbed 
and eliminated. The origin of the second, is not really known, 
but it is supposed to be an indirect product of creatine. Both 
are constituents of the blood and urine of animals. The urates 
are formed by the union of the bases, soda, potassa and ammonia 
with uric acid. They are crystallizable substances, soluble in hot 
water and alcohol, but insoluble in ether. The most abundant 
of these constituents is urate of soda, which, in importance, ranks 
next to urea. Its origin is not known; but it is formed, probably, 
either in the tissues or blood, and absorbed and eliminated by 
the kidneys. Besides these elements, certain organic matters are 
found in the urine, and many substances as iodine, quinine, ether 
and sugar pass out of the circulation through this channel. 
102. Carbonic acid, the second of the excrementitious sub- 
stances, is eliminated from the system in various ways, hut princi- 
pally in expiration. It is formed by the decomposition of sugar 
in the tissues, and is not, as was formerly supposed, the result of EXCJRETION. 
83 
oxidation. It is absorbed by the blood, which conveys it to the 
lungs, where it is exhaled in a gaseous form. The amount thus 
thrown out of the system varies in persons of different ages and 
constitutions, always being greater in the male, when the mus- 
cular system is fully developed. This vital phenomenon is an 
important factor in Nature’s economy. The vegetable world 
inhales the carbonic acid, which it transforms into its structures. 
The animal world assimilates the oxygen for the nutrition and 
development of its tissues. The existence of the one is depend- 
ent upon, and implies that of the other. 
103. From the foregoing synopsis of the nutritive processes, 
we are able to form an approximate idea of the quantity of daily 
ingesta and egesta. The following table, given by Dr. Dalton, 
is the result of careful experiment: 
Absorbed during 24 hours. 
Oxygen, . . . 1.470 lbs. 
Water, .... 4.535 “ 
Albuminous matter, . .305 “ 
Starch, 660 “ 
Fat, . .220 “ 
Salts, 040 “ 
Total, . . 7.230 
Discharged in 24 hours. 
Carbonic Acid, . . 1.630 lbs.' 
Aqueous Vapor, . . 1.155 “ 
Perspiration, . . 1.930 “ 
Water of Wine, . . 2.020 “ 
Urea and Salts, . . .137 “ 
Feces, 358 “ 
Total, . . 7.230 
104. The materials thus absorbed are decomposed, and actu- 
ally combine with the tissues. Under the influence of the vital 
functions the entire substance of the body is thus constantly 
replaced by new tissues. 84 
COMMON SENSE MEDICAL ADVISEE. 
Fig 53. 
Nervous System. CHAPTER XII. 
PHYSIOLOGICAL ANATOMY. 
THE NERVOUS SYSTEM. 
105. All the symmetry of the human form — the perfect ad- 
justment of its parts — the harmonious blending of strength and 
elasticity—would be futile without the agency of this vitalizing 
system of power. Hitherto we have considered the anatomical 
and functional characteristics of the organs employed in Diges- 
tion, Circulation and Iiespiration; we have found the living 
process of nutrition to be, in all its essential features, a resultant 
of physical and chemical forces; and we have also traced the 
gradual evolution of the latent germ from its mystic birth to ma- 
turity; but in each instance we have presupposed the existence 
and activity of the nerves. Without their vivifying influence, 
man would not be an active, sentient being — only an inanimate, 
worthless organism. The nerves are omnipresent. There is not 
an inch of bodily tissue into which their delicate filaments and 
ramifications do not penetrate, and form a network of conductors 
over which are sent the stimuli of volition, feeling and instinct. 
They may aptly be termed the agents of life. 
106. Three fundamental modifications of neurine enter into 
the composition of the nerves; (1), minute masses of a grayish or 
ash-colored, granular substance, termed ganglion globules; (2), 
a white, fibrous tissue which serves to connect the nerve centers; 
(3), gelatinous fibres,—of an oval form,—which, when united in 
cords, present a yellowish-gray color. These mutations are 
respectively termed, by anatomists, the vesicular, fibrous or 
tubular and gelatinous neurine. 86 
COMMON SENSE MEDICAL ADVISER. 
107. The fibres, when collected in bundles, are termed nerve- 
trunks or cords. These cords may be separated into filaments 
which are imperceptible to the naked eye. Thousands of them 
are contained within the space of a single inch. The minutest 
filaments are found in the brain, and have an average diameter 
of one ten thousandth of an inch; but in the spinal cord and its 
numerous branches, they do not exceed one three thousandth of 
an inch in diameter. The “ ultimate nervous filaments ” are cylin- 
drical in form, and, under the microscope, reveal transparent, 
membranous coverings, within which is contained the “ white sub- 
stance of Schwann ”—(a semi-fluid, nervous matter which becomes 
granular by coagulation and possesses some refractive power). 
The axis cylinder occupies the center and is composed of matter 
which has a glistening appearance when exposed to reflected light. 
The position of this substance is analogous to that of the me- 
dulla in the bones. The investing membrane is continuous from 
the origin to the termination of the nerve-trunk. 
The central portion of the fibrous neurine has 
been proven to be the conducting medium of 
motory influences. 
108. The ganglions are cellular globules 
of irregular forms and possess fibrous append- 
ages, which serve to connect them with other 
cells. These ganglions form the cineritious 
or cortical covering of the brain, and are con- 
tained in the interior of the spinal cord. Accord- 
ing to Kolliker, the largest of these nerve cells, 
measures only of an inch in diameter. The 
accumulations of the nervous globules which 
form the ganglions are termed ganglia. The 
brain is a collection of nervous ganglia. 
109. Nerves are distinguished with reference 
to their origin, as cerebral—in the brain — or 
spinal—in the spinal cord. Their arrangement is either anasto- 
motic or plexiform. In the former case several are united in a 
sheath—for example, in the anterior and posterior roots of the 
spinal nerves—, or they may form arches, as in the extremities 
of the fingers, and the fibres of the optic nerve. In the latter, the 
plexus may be either ganglionic, where the interchange of fibres 
Fig. 5J+, 
Division of a 
nerve showing 
portion of a ner- 
vous trunk (a) and 
separation of its 
filaments (6, c, d,e.) THE NERVOUS SYSTEW. 
87 
takes place in the cell, or terminal, which is formed by the inter- 
lacement of the fibres of the peripheral system. 
With reference to structure, and function, nerves are distin- 
guished as cerebrospinal and sympathetic. There are also two 
classes of fibres,— the media of sensation, or sensory fibres—, 
and the instruments of power, or motory fibres. The latter have 
been termed by Moi'ton, “the conductors of the will.” Each 
nerve is supplied with arteries, and their capillaries are always 
parallel to the fibres. 
110. Nearly all the strictly scientific knowledge which we 
possess of the nervous system, has been obtained within the last 
century. In neurology, as in all sciences, there have been theo- 
ries, experiments and failures. Yet there are two fundamental 
facts upon which all its investigators agree. (1.) The vesicular 
neurine is the source of nervous power, of which the fibres are 
the media for its transmission. (2.) The activity of the nervous 
system is dependent upon the rapidity of the chemical changes 
which take place between the oxygen of the blood and the 
nervous elements. A copious supply of fresh, oxygenated blood 
is the fountain of nervous power; hence, the necessity of pure 
air for all persons engaged in mental labor. It is estimated that 
nearly one-fifth of the blood is employed for the use and repara- 
tion of the brain. Nervous force is the product of these chemical 
changes. The nature of this force has been made a subject of 
earnest inquiry. It is analogous to electricity—but there exist 
as many differences as between electricity and heat — both of 
which may be considered as modifications of motion. The 
alleged similarities may be summarily stated: (1.) Not only are 
the nerves sensible to the electric current, but there is also an 
identity in their effects upon the muscular fibres. (2.) The in- 
stantaneous and invisible transmission of force. (3.) The phe- 
nomena of electric fishes, and the presence of electricity in the 
system during nervous action. But electricity is only one, of 
many physical agents which will produce the same effects, and 
we can attribute them to the one, as well as the other. The 
gymnotus and torpedo are furnished with special organs for the 
generation of electricity, (Brown-Sequai’d); and the presence of 
electricity in the nerve current has never been proved by expe- 
riment. Again, electricity must#be transmitted through isolated 88 
common sense medical advisee, 
conductors; but nerves show no such conditions. If a nerve 
be severed and the extremities placed in opposition, the elec- 
tric current will readily pass over them, while the nerve-currents 
will not. This is evident from their paralyzation. Experiments 
have proven that nerve force, or nervaura, or whatever we 
may please to term it, can have only one-tenth of the velocity of 
the electric current. One of the great difficulties of science is 
to designate imponderable agents; for, to the general reader, the 
terms convey an idea of material existence. Whenever we speak 
of nervous force, nerve-energy, etc.,we refer to a force as immate- 
rial and imponderable as magnetism, electricity, heat, or motion. 
111. According to their collective functions, we may classify 
the nerves as belonging to the sensory, the motory, or the excito- 
motory systems. The minute filaments of the first class are 
found in every part of the cutaneous tissue, and have, for their 
terminus, the brain. They convey impressions from without, 
inward, and sustain an intimate relation to our emotional nature. 
The motory fibres originate in the interior centers, are distributed 
to every part of the cuticle, and transmit the outgoing impulse 
of action to the muscles. The excito-motory system compre- 
hends all those nerve-trunks in which we find an apposition of 
the sensory and motory fibres:—as examples of this class, we 
may cite the pneumogastric and spinal accessory nerves, which 
both excite and transmit motory impulses. It is a remarkable 
fact, that the microscope does not reveal the slightest difference 
between the component structures of' the sensory and motory 
filaments; but that there is one system for motion and another 
for sensation, is a fact, proved by experience, and sanctioned by 
anatomists. 
CEREBRO-SPINAL SYSTEM. 
112. This system is divided into the spinal cord, the medulla 
oblongata and the brain. 
113. The Spinal Cord is a continuous scries of ganglia, 
enveloped longitudinally by nervous filaments, and contained in 
a long cavity, called the “spinal canal.” From this nerve are 
distributed fibres and filaments to the muscles and integument, of 
at least nine-tenths of the body. Careful experiments have 
proved that sensation and motion occupy special parts; but in CEREBKO-SPIXAL SYSTEM. 
89 
many of the nerves they are so intimately connected that an 
injury or bruise destroys both powers simultaneously. In the 
spinal cord the phenomena are different. If the anterior roots be 
subjected to experiment, there will result convulsive movements, 
but no evidence of sensation; if the irritant be applied to the pos- 
terior root, the subject will experience acute pain but no motion. 
114. With regard to the mode of action of the spinal cord, 
we may enumerate three demonstrable facts, stated by Dr. Dal- 
ton:—(1.) “An irritation applied to a spinal nerve, at the middle 
of its course, produces the same effect as if the sensation, thus 
caused, traversed its entire length.” (2.) “ An irritation of the 
motory filaments disappears from within, outward, that of the 
sensitive filament, from without, inward.” (3.) “Each nervous 
filament acts independently of the rest throughout its entire 
length, and does not communicate its irritation to those which 
are in proximity with it.” We have associated sensations, as 
when the sight of a luscious peach, or any favorite fruit, excites 
the sensation of taste,— and also associated movements, the 
most perfect illustration of which is in the consensual movements 
of the eyes, termed binocular vision. The anterior and posterior 
roots of the spinal nerves differ in their mode of transmitting the 
nervous current, and able experimenters have proved that in the 
anterior roots the impulse is conveyed from within, outward, and 
in the posterior, from without, inward. The same mode of affer- 
ent and efferent action is found to exist in the cord itself. 
115. The external membrane of the spinal corcl has a fibrous, 
opaque structure, and is termed the dura mater. It consists of 
two laminae of cellular tissue, and forms a sheath for the spinal 
nerves. Before removal by dissection, it is much larger than the 
cord. The tunica arachnoidoe is a transparent tissue which 
envelops the brain, and is reflected over the dura mater, thus 
forming a sac. The pia mater is a soft membrane of slight vas- 
cularity, and lies in intimate contact with the cord itself. The 
ligamentum denticulatum derives its name from its use and 
structure. It supports the three membranes, and is attached to 
the pia mater by twenty or more processes. Two longitudinal 
fissures divide the cord into lateral halves, while two furrows 
subdivide these halves, and traverse the entire length. For a 
cross-section of the spinal cord, see Fig. 55. Dissection shows it 90 
COMMON SENSE MEDICAL ADVISEE, 
to be composed of vesicular neurine, with an external covering 
of fibrous tissue. The spinal 
cord has been termed an 
“inverted brain.” It is 
problematically true that, if 
all the gray matter of the 
nerves could be collected, it 
might equal, if not exceed 
in quantity, that contained 
in the brain. Thirty-one 
spinal nerves are distributed 
to the bodily organs. Eight of these are termed Cervical, twelve 
Dorsal, five Lumbar, and six Sacral, according to the portion of 
the cord from which they proceed. 
The filaments, or branches of the spinal nerve, penetrate every 
particle of the cutis vera. The contact of the point of a pin 
with any portion of the bodily surface, gives rise to a distinct 
sensation, which, reflected as a motor impulse, stimulates the 
muscles to action. Injury or destruction of the spinal nerves 
produces either paralysis of sensation, paralysis of motion, or 
both. If a spinal nerve be severed at any part of its course, it 
will ultimately unite if placed in contact, and sensation will be 
restored. The posterior roots, at their junction with the cord, 
are distinguished from the anterior, by the presence of a gray 
ganglion or swelling of vesicular neurine. See (a), Fig. 56. 
Fig. 55. 
Transverse section of spinal cord. 
REFLEX ACTION OF THE SPINAL CORD. 
116. The Spinal cord may be considered as a distinct nervous 
center, in which originate and terminate all those involuntary 
stimuli that exert so potent an influence in the preservation and 
economy of the body. This reflex action is a special function of 
the spinal nerves, and serves as a monitor and regulator of the 
organs of nutrition and circulation, by placing them, ordinarily, 
beyond the control of conscious volition. If the foot of a de- 
capitated frog be irritated, there is an instant contraction of the 
cori’esponding limb; if tlie irritation be intense the other limb 
will also contract. These motions indicate the existence, in some 
part of the spinal axis, of a distinct, nervous center capable of 
converting and reflecting impulses. It is found, by experiment, KEFLEX ACTION OF THE SPINAL CORD. 
91 
that the same movements will take place if the irritation he ap- 
plied to any portion of the body to which the spinal nerves are 
distributed, thus giving undoubted evidence that the spinal cord, 
in its entirety, is susceptible of these reflections. Fig. 56 repre- 
sents the direction and flow of the nervous currents. The 
sensory current passes upward along the 
posterior root, (a) until it reaches the im- 
bedded gray matter (b) of the cord, by 
which it is reflected, as a motor impulse, 
downward, along the anterior root, (c) to 
the muscles whence the sensation was re- 
ceived. This is the reflex action of the 
spinal cord. There is no conscious volition 
or sensation connected with this motor im- 
pulse; and the removal of the brain and the 
sympathetic does not diminish its activity. 
Even after death it continues for some time—longer in cold, than 
warm-blooded animals, on account of the difference in temper- 
ature— thus showing the activity of the spinal cord. By dis- 
ease, or the use of certain poisons, this activity may be greatly 
augmented, and is very distinctly observable in the human 
subject. A sudden contact with a different atmosphere will 
induce these movements. The contraction of muscles experi- 
enced by all persons, in stepping into a cold bath, or emerging 
from the cozy sitting-room into a chilly December temperature, 
are familiar illustrations of these movements. The existence of 
these actions has enabled M. Bernard, a distinguished physiol- 
ogist, to demonstrate two important facts, viz: that the irritability 
of the muscles may be injured or destroyed, while that of the 
nerves distributed to them, remains unchanged; and that the 
motory and sensory filaments may be paralyzed independently 
of each other. 
Fig. 56. 
117. The reflex actions of the spinal cord have been admir- 
ably summarized by Dr. Dalton, as exerting a general, protective 
influence over the body, presiding over the involuntary action of 
the limbs and trunk, regulating the action of the sphincters, 
rectum and bladder, and at the same time exercising an indirect 
influence upon the nutritive changes in all parts of the body, to 
which the spinal filaments are distributed. COMMON SENSE MEDICAL ADVISEE. 
To the researches of Sir Charles Bell, we are indebted for the 
discovery and proof of the reflex actions of the nervous system, 
which, taken collectively, exercise a conservative influence over 
the animal economy. 
118. The Medulla Oblongata. This organ is a 
bulbous ganglion, situated above the spinal cord and connected 
with the brain. It has distinct functions which are employed in 
the preservation and continuance of life. It has been termed the 
“ vital knot,” owing to the fact, that the brain may be removed 
and the cord injured, but the heart and lungs will continue to 
perform their functions, until the medulla oblongata is destroyed. 
This ganglion, although small, possesses such a sway over life, 
that the author has deemed it of sufficient importance to accord 
it a separate consideration. The spinal nerves, before enter- 
ing this ganglion, decussate. By some authors this crossing of 
the sensory and motory filaments is supposed to take place near 
the medulla oblongata. Dr. Brown-Sequard shows that it takes 
place at every part of the spinal cord. The medulla oblongata is 
Fig. 57. 
Fig. 58. 
traversed by a longitudinal fissure, continuous with that of the 
spinal cord. Each of the lateral columns tlms formed are sub- 
divided into partitions termed respectively,— the Corpora Pyra- 
midalia, the Corpora Olivaria, the Corpora Restiformia and the 
Posterior Pyramids. REFLEX ACTION OF TIIE SPINxVL CORD. 
93 
The Corpora Pyramidalia (see 1, 1, Fig. 57.) are two 
small medullary eminences or cox-ds, 
situated at the occipital surface of the 
medulla oblongata; approaching the 
Pons Varolii they become larger and 
rounded. 
The Corpora Olivaria (3, 3, Fig. 
57. are two elliptical prominences, 
placed exterior to the corpora pyi-a- 
midalia. By some physiologists these 
bodies are considered as the nuclei, or 
vital points of the medulla oblongata. 
Being closely connected with the 
nerves of special sensation, Dr. Solly 
supposed that they presided over the 
movements of the larynx. 
The Corpora Restiformia (3,5, Fig. 
58. are lateral and posterior rounded 
projections of whitish medulla, which 
pass upward to the cerebellum and 
form the crura cerebelli—so named 
on account of their leg like appear- 
ance. In these ganglia originate 
and tei’minate the filaments of the 
pneumogastric neiwe. 
The' Posterior Pyramids, which 
are sometimes termed fasciculi 
graciles (slender bundles), are much 
smaller than the other columns of 
the medulla oblongata. They are 
placed (4, f Fig- 58.) upon the 
mai-gin of the posterior fissui’es in 
contact with each other. 
120. The functions of the me- 
dulla oblongata, which begin with the earliest manifestations of 
life, have an instinctive chax*acter. The newly born infant, when 
placed at its mother’s breast, acts from the motor impulse of this 
organ and performs all the movements necessai-y for appropri- 
ating its food. If the cerebellum and cerebrxxm of a dove be 
Fig. 59. 
Section of the brain and an ideal 
view of the pneumogastric nerve 
and its branches, a. Vertical sec- 
tion of the cerebrum, b. Section of 
the cerebellum, e. Corpus cal- 
losum. d. Lower section of me- 
dulla oblongata. Above d, origin 
of the pneumogastric nerve. 1. 
Pharyngeal branch. 2. Superior 
laryngeal. 3. Branches to the lungs. 
U. Branches to the liver. 5. Branch- 
es to the stomach. 94 
COMMON SENSE MEDICAL ADVISER. 
removed, the bird will make no effort to procure food, but if a 
crumb of bread be placed in its bill, deglutition takes place natur- 
ally and without any special effort. So also in respiration, the 
lungs continue to act after the inter-costal muscles are paralyzed; 
if the diaphragm lose its power, suffocation is the result, but 
there will still be a convulsive movement of the lungs, indicating 
the continued action of the medulla oblongata. 
121. The Pneumogastric nerve (from the wandering course 
of its fibres, often called the par vagum), is distributed to the 
principal vital organs, viz: lungs, heart, stomach and liver. At 
the corpora restiformia it is exclusively a sensitive nerve. After 
passing downward through the posterior foramen lacerum, it be- 
comes a mixed nerve, and is intimately associated with the spinal 
accessories and glosso-pharyngeal nerves (see Fig. 59 and ex- 
planation). The respiratory movements of the glottis so essen- 
tial to the preservation of life are controlled by the impulses 
received through the motor filaments of this nerve. 
THE GREAT SYMPATHETIC. 
122. A double chain of nervous ganglia, extends from the 
anterior, to the posterior parts of the body, parallel to, and in 
front of the spinal column, and is termed, collectively, the system 
of the great sympathetic. These ganglia are intimately con- 
nected by nervous filaments and communicate with the cerebro- 
spinal system by means of the motory and sensory filaments 
which penetrate the sympathetic. The nerves of this system 
are distributed to those organs over which conscious volition 
has no direct control. 
123. Four of the sympathetic centers, situated in the front 
and lower portions of the head, are designated as the ophthalmic, 
spheno submaxillary and otic ganglia. The first of 
these, as its name indicates, is distributed to the eye, penetrates 
the sclerotic (the white, opaque portion of the eyeball, with its 
transparent covering) and partly controls the contraction and 
dilation of the iris. The second division is situated in the angle 
formed by the sphenoid and maxillary bone (just below the ear). 
It sends motory and sensory filaments to the palate, and velum 
palati. Its filaments penetrate the carotid plexus, receive rein- 
forcements from the motor centers of the facial nerve and the TIIE GREAT SYMPATHETIC. 
95 
Fig. 60. 
Course and distribution of the great Sympathetic Nerve. 96 
COMMON SENSE MEDICAL ADVISER. 
sensory fibres of the superior maxillary. The third division is 
located on the submaxillary gland. Its filaments are disti-ibuted 
to the sides of the tongue, the sublingual, and submaxillary 
glands. The otic ganglion is placed below the base of the skull 
and also connects with the carotid plexus. Its filaments of dis- 
tribution supply the internal muscles of the malleus (the largest 
bone of the tympanum), the membranous linings of the tym- 
panum and the eustachian tube. Three ganglia, usually desig- 
nated as the superior, middle, and inferior, connect with the 
cervical, and spinal nerves. Their interlacing filaments are dis- 
tributed to the muscular walls of the larynx, pharynx, trachea 
and esophagus, and also penetrate the thyroid gland. 
Observation 1 St. The use of this gland is not accurately 
known. It is composed of a soft, brown tissue, and consists of 
lobules contained in lobes of larger size. It forms a spongy cover- 
ing for the greater portion of the larynx, and the first section of 
the trachea. That it is an important organ, is evident from the 
fact that it receives four large arteries, and filaments from two 
pairs of nerves. 
Observation Sd. In tracheal consumption, physicians 
often prass upon the cervical vertebrae, and in front of the 
mastoid process, to ascertain the degree of sensibility of the 
branches of the otic nerve. By this means they are enabled to 
locate the affection and distinguish it from bronchial consumption. 
124. The sympathetic ganglia of the chest correspond in 
number to the terminations of the ribs, over which they are 
situated. Each of these ganglia receives two filaments from the 
intercostal nerve, situated above it, thus forming a double con- 
nection. The thoracic ganglia supply the thoracic aorta, 
esophagus and lungs with motory fibres. 
In the abdomen the sympathetic centers are situated upon the 
coeliac artery and are termed, collectively, the semi-lunar cceliac 
ganglion. Numerous inosculating branches radiate fronj this 
center and are called, from the method of their distribution, the 
“solar plexus.” From this, also, originate other plexuses which 
are distributed to the stomach, liver, kidneys, intestines, spleen, 
pancreas, renal capsules and the organs of generation. Four 
other pairs of abdominal ganglia, connected with the lumbar 
branches are united by filaments to form the semi-lunar ganglion. THE GREAT SYMPATHETIC. 
97 
The sympathetic ganglia of the pelvis consist of five pairs, 
which are situated upon the surface of the sacrum (so called be- 
cause it protects the genital organs, which were deemed sacred 
by the ancients). At the extremity of the spinal column 
this system terminates in a single swelling, designated as the 
“ganglion impar.” 
125. Owing to the position of the sympathetic ganglia, 
deeply imbedded in the tissues of the chest and abdomen, it is 
exceedingly difficult to subject them to any satisfactory experi- 
ments. A few isolated facts form the basis of all our knowledge 
concerning their functions. They possess the powers of sensibil- 
ity and motion, only are more sluggish in their operations than in 
the cerebro-spinal system. All parts, to which their branches are 
distributed, furnish evidence of this statement. The contraction 
of the iris is one of the most prominent examples; we may also 
cite the sympathetic action of the internal organs of the abdomen. 
126. In all the reflex actions of the special nerves, the sensa- 
tion is transmitted through the cerebro-spinal system, from which 
the motor impulse is sent to the muscles by the sympathetic 
ganglia. Physiologists enumerate three kinds of reflex actions, 
which are either purely sympathetic, or partially influenced by 
the cerebro-spinal system. Dr. Dalton states them as follows: 
“ The first class includes all those reflex actions in which the 
irritation is applied to the internal organs, and the impulse passes 
through the sympathetic and cerebro-spinal system, to the 
voluntary muscles and sensitive surfaces.” 
Secondly, “ Keflex actions taking place from the sensitive sur- 
faces through the cerebro-spinal and sympathetic systems, to the 
involuntary muscles and secreting organs.” Apprehension,terror, 
and a narrative of crime will operate through the organs of fear, 
and thus indirectly, speedily, and sometimes dangerously, affect 
the processes of digestion and secretion. Fear causes the mouth 
to become dry — the salivary glands cease their action and after 
the occurence the victim has no desire for food, a condition popu- 
larly termed “loss of appetite;” but the real cause is that the or- 
gans of digestion are temporarily paralyzed and unprepared to 
receive the food. Upon this fact is founded one of the axiomatic 
laws of health, viz: that during the process of digestion the mind 
should be free from all depressing influences. Ill temper may 98 
COMMON SENSE MEDICAL ADVISER. 
effectually destroy all the healthful tendencies of a robust organ- 
ization, while cheerfulness, on the contrary, is one of the most 
efficient remedies for human ills. And this illustrates the fact 
that fear, when abnormally excited, produces those irritations 
and disturbances, which develop chronic diseases. Its depressing 
influence is well known in cholera epidemics. The bowels, being 
paralyzed, are uncontrolled and pour out their contents until 
collapse and complete coma supervene. 
127. “The third class embraces all those reflex actions taking 
place through the sympathetic system from one part of the inter- 
nal organs to another.” We may mention the movements of the 
digestive apparatus, occasioned by the contact of food with its 
lining membrane. The reader may supply many similar illustra- 
tions, where the functions of one organ act as an excitant to 
those of another, which, in turn, instinctively prepares for the 
discharge of its duties. 
From this brief synopsis we cannot fail to recognize the fact, 
that by far the greater portion of the vital power, which preserves 
and ensures life, lies entirely beyond the realm of volition. 
128. Tlie Brain. The Cerebellum, or little brain, is 
situated beneath the tentorium (a tent-like process of the dura 
mater which separates it from the cerebrum), and in the posterior 
chamber of the skull. It is convex, with a transverse diameter 
of three and one-half, or four inches, and is a little more than 
two inches in thickness. It is divided into hemispheres by a 
longitudinal ridge, termed the superior vermiform process, and 
by a fissure, parallel with the first, below and behind. Another 
longitudinal ridge observed in this groove, or sulcus is termed the 
vermis inferior. The substance included between these vermiform 
processes was termed, by Gall and Spurzheim, the “fundamental 
portion.” When carefully examined the cerebellum is found to 
consist of delicately laminated neurine, compactly arranged, but 
separated by the pia mater. A horizontal fissure passes around 
each hemisphere, and divides it into two parts. This, in turn, 
gives rise to other furrows, running in almost every direction. 
The vesicular neurine composes the greater part of the cerebel- 
lum. From the beautiful arrangement of the fibrous tissue, it has 
been termed the “ arbor vitce.’’’’ The ganglion of the cerebellum. 
is an irregular mass of cineritious matter, contained within the THE BRAIN". 
99 
trunk of this imaginary tree; within the ganglion is the nucleus 
of the medullary substances. 
129. The Peduncles of the Cerebellum, or the media by which 
it communicates with the other portions of the brain, are divided 
into tlmee pairs, designated as the superior, middle, and inferior. 
The first, pass upward and forward until they are blended with 
the tubercles of the corpora quadrigemina. The second, are the 
crura cerebelli which unite in two large fasciculi or pyramids, 
and are finally lost in the Pons Varolii. The inferior peduncles 
are the corpora restiformia, previously described, and consist of 
both sensory and motory filaments. Some physiologists suppose 
that the cerebellum is the source of that harmony or associative 
power, which systematizes all voluntary movements, and effects 
that delicate proportion of cause to effect, displayed in muscular 
action. This fact may be proved, experimentally, by removing 
the cerebellum of a bird, and noting the results, which are an 
uncertainty in all its movements, difficulty in standing or walking, 
and a rapid, or confused fluttering of its wings. In the animal 
kingdom we find an evident correspondence between the size of 
the cerebellum, and the variety and extent of its action. Instances 
are cited in which no such proportion exists, and so the matter 
is open to controversy. The general function of the cerebellum, 
therefore, cannot be explained, but the latest experiments of 
physiological and anatomical science seem to favor the theory, 
that it is in some way connected with the harmony of movements. 
This “co-ordination,” by which the adjustment of voluntary 
motion is supposed to be effected, is not in reality a “faculty ” 
having an existence in brain substance, but the harmonious action 
of many forces through the cerebellum. 
130. The Cerebrum occupies five times the space of all the 
other portions of the brain taken collectively. It is of an ovoid 
form, and becomes larger as it approaches the posterior region 
of the skull. A longitudinal fissure formed by the dura mater 
separates the cerebrum into two hemisphei'es,which are connected 
at the base of the fissure, by a broad medullary band, termed the 
corpus callosum. Each hemisphere is subdivided into’three lobes. 
The anterior, gives form to the forehead, the middle, rests in the 
cavity at the base of the skull, and the posterior lobe is supported 
by the tentorium, by which it is separated from the cei-ebellum 100 
COMMON SENSE MEDICAL ADVISER. 
beneath. One of the most prominent characteristics of the cere- 
brum is its many, and varied convolutions. These do not corres- 
pond in all brains, nor even on the opposite sides of the same 
brain, yet there are certain features of similitude to which all 
conform; accordingly, anatomists enumerate four orders of con- 
volutions. The first order begins at the substantia perforata and 
passes upward and around the corpus callosum toward the 
posterior margin of that body, thence descends to the base of 
the brain, and terminates near its origin. The second order 
originates from the first, and subdivides into two convolutions, 
one of which composes the exterior margin and superior part of 
the corresponding hemisphere, while the other forms the circum- 
ference of the fissure of Sylvius. The third order, from six to eight 
in number, is found in the interior portion of the brain and in- 
osculates between the first, and second orders. The fourth, is 
found on the outer surface of the hemisphere, in the space be- 
tween the sub-orders of the second class. A peculiar fact relating 
to these convolutions is noticed by all anatomists, viz: mental de- 
velopment is always accompanied by an increasing dissimilarity 
between their proportional size. The cineritious matter, which 
forms their external covering, is termed by Solly, the “hemi- 
spherical ganglion.” The encephalic nerves are twelve in number. 
The cerebral hemispheres may be injured, or lacerated without any 
pain to the patient. The effect seems to be one of stupefaction 
without sensation, or volitional impulse. A well developed brain 
is a very good indication of intelligence and mental activity. 
That the cerebrum is the seat of the reasoning powers, and all the 
higher processes of intellection may be proved by three experi- 
ments. (1.) If this portion of the brain be removed, it is accom- 
panied by loss of intelligence. (2.) If the human cerebrum be 
injured, there is an impairment of these powers. (3.) In the 
animal kingdom there is a gradual increase in the size of the 
cerebrum, corresponding in each instance to a gradual increase 
of intellectuality. One modification of this general law of de- 
velopment, is the differences in the cerebral texture. Men possess- 
ing comparatively small brains, may have a vast range of thought 
and acute reasoning powers. Anatomists have found these pecul- 
iarities to depend upon the quality, or fineness of the texture of 
the nervous matter, as well as upon size and development. THE BRAIN". 
101 
131. In the cerebro-spinal system we have discovered three 
different kinds of reflex actions. (1.) Those of the spinal cord 
and medulla oblongata are performed without any conscious 
volition, or sensation on the part of the subject. (2.) The second 
class embraces those of the tuber annulare, where the perception 
gives rise to motion without the interference of the intellectual 
faculties. These are denominated purely instinctive reflex actions, 
and include all those operations of animals, which seem to display 
intelligent forethought; thus, the beaver builds his habitation 
over the water, but not a single apartment is different from the 
beaver homestead of a thousand years ago,— no improvement, 
—no retrograde. The intelligent trains of thought, the product of 
cerebral functions, have been termed a third class of reflex actions. 
It is evident that this power is, in a degree, possessed by some 
of the lower animals:—for instance, a tribe of monkeys on a 
foraging expedition will station guards at different parts of the 
field, to warn the plundex-ers of the approach of danger. A cry 
from the sentinel, and general confusion is followed by retreat. 
Reason only attains its highest development in man, in whom it 
passes the bounds of ordinary existence, and with the magic 
wand of love, reaches outward into the vast unknown, lifting 
him above corporeal being, into an atmosphere of spiritual and 
divine Truth. CHAPTER XIII. 
THE SPECIAL SENSES. 
SIGHT. 
132. The eye is the organ through which we perceive, by 
the agency of light, all the varied dimensions, relations, posi- 
tions, and visible qualities of external objects. It receives 
outward impressions, and, in man, reflects all the thoughts, ideas 
and passions, which, in their aggregate, form the sum total of 
individuality and individual experience. 
133. The number, position, and perfection of the eyes, vary 
in different orders, in each instance corresponding to the mode 
of life, habitation and food of the animal. A skillful optician 
can ascertain by the peculiar formation of the eye — with no 
reference to the general physical structure — in what element the 
animal lives. Sight is the most perfect of the senses, and reveals 
to man the world of beauty. The esthetic sentiment is acknowl- 
edged to be the most refining element of civilized life. Painting, 
sculpture, architecture, and all the scenes of nature,—from a tiny 
Avayside flower to a Niagara,—are subjects in which the poets’ eye 
sees rich beauties to mirror forth in the rhythm of verse. 
134. In all the higher orders of animals, as the vertebrates, 
the organs of vision are supplied with filaments from the second 
pair of cerebral nerves. They are collectively, termed the optic 
nerve. In this class, the eyes are limited to tAVO in number, and 
placed in rounded caArities of the skull, beneath the anterior 
lobes of the cerebrum. Three membranes form the lining of this SIGHT. 
inner sphere of the eye, called, respectively, the Sclerotic, 
Choroid and Retina. 
135. The Sclerotic, or 
outer covering, is the 
white, firm membrane, 
which forms the larger 
visible portion of the 
eyeball. It is covered 
in front by a colorless, 
transparent segment,— 
the cornea,—which gives 
to the eye its lustrous 
appearance. Within the 
sclerotic, and lining it 
throughout, is a thin, dark membrane termed the Choroid. Be- 
hind the cornea it forms a curtain, called the iris, which gives to 
the eye its color. The muscles of the iris can contract or dilate 
according to the amount of light received, and the central 
opening, thus formed, is called the pupil. The Retina, is formed 
by the optic nerve which penetrates the sclerotic and choroid 
and spreads out into a delicate, grayish, semi-transparent mem- 
brane. The retina is the essential organ of vision, and consists of 
two laminse, the one formed of medulla, the other, of fibro- 
vascular neurine. A spheroidal, transparent body, termed the 
crystalline lens, is situated directly behind the pupil. It is of 
varying density, increasing from without, inward, and forms a 
perfect refractor of the light received. The space in front 
of the crystalline lens is separated by means of the iris into 
two compartments called, respectively, the anterior and pos- 
terior chambers. The fluid contained within them, termed 
the aqueous humour, is secreted by the cornea, iris and 
ciliary processes. The space, posterior to the crystalline lens, 
is occupied by the vitreous body or humour. This humour 
is denser than the other fluids and has the consistency of 
jelly, being perfectly transparent. “The function of the crys- 
talline lens is to produce distinct perception of form and 
outline.” * The transparent humours of the eye also contribute 
to the same effect, but only act as auxiliaries to the lens, without 
Fig. 61. 
* Dalton—Human Physiology, last edition. 104 
COMMON SENSE MEDICAL ADVISER. 
which our visual impressions would be of confused, formless 
luminosity. 
136. The accompanying figure 
represents the course of the rays 
of light proceeding from the ob- 
ject (a b) refracted by the lens, 
and forming the inverted image 
x y on the screen. All rays of 
light proceeding from b will be 
concentrated to y, and those proceeding from a will converge to 
x. Rays of light emanating from the center of the object a b 
will pursue a parallel course, and form the center of the image. 
Rays of light passing through a double convex lens (the crystal- 
line lens is of this form) converge to a point called the focus. In 
the organ of vision, if perfect, the focus is on the retina, which 
serves as a screen to receive the image or impression. Here the 
optician meets with a serious difficulty; We have a distinct 
perception of the outline of a distant hill, and also of a book 
lying before us. The rays of light we receive from these ob- 
jects, cannot have the same focus. IIow then can we account 
for the evident accomodation of the eye to the varying distances? 
Various suppositions have been advanced to explain this 
adjustment; as, changes in the curvature of the cornea, and lens; 
a movement of the lens, or, a general change in the form of the 
eyeball, by which the axis may be lengthened or shortened. 
Fig. 62. 
137. Two facts constitute all tlie positive knowledge we 
possess on this subject. Every person is conscious of a muscular 
effort in directing the eye to a near object, as a book, and of 
fatigue, if the attention is prolonged. If now the eyes be di- 
rected to a distant object, there will result a sense of rest or pas- 
sivity. By various experiments it has been proved that the 
accomodation or adjustment of the eye, is an active condition for 
near objects, but for distant objects, essentially passive. An in- 
crease in the convexity of the crystalline lens, is now admitted to 
be the condition for a distinct perception of near objects. We 
may give two simple illustrations, cited by Dr. Dalton in his recent 
edition of Human Physiology. If a candle be held near the front 
of an eye which is directed to a distant object, three reflected im- 
ages of the flame will be seen in the eye, one on each of the anterior HEARING. 
105 
surfaces of the cornea and lens, and a third in the posterior sur- 
face of the latter. Now if the eye be directed to a near object, 
the reflection on the cornea remains unchanged, while that on 
the anterior surface of the lens gradually diminishes and approx- 
imates in size to the reflection on the cornea, thus giving conclu- 
sive evidence that in viewing a near object, the anterior surface 
of the crystalline lens, becomes more convex, and at the same 
time approaches the cornea. Five or six inches is the minimum 
limit of the muscular adjustment of the eye. From that point to 
all the boundless regions of space, to every star and nebulie that 
send their rays to our planet, human vision can reach. It is the 
sense by which we receive knowledge of the myriads of worlds 
and suns which circle with unfailing precision through infinite 
space 
138. Hearing depends upon the sonorous vibrations of the 
atmosphere. The waves of sound strike the sensitive portions of 
the ear, and their impressions upon the auditory nerves are termed 
the sensations of hear- 
ing. The ear is di- 
vided into three parts 
called, respectively, 
the External, Middle 
and Internal ear. 
139. The external 
organs of hearing are 
two for each animal, 
and placed on oppo- 
site sides of the head. 
In the higher order 
of vei’tebrates, they 
are so situated as to 
give expression and 
proportion to the 
facial organs, and, at 
the same time, to 
answer the requirements of sensuous life. 
140. The External ear is connected with the interior apart- 
ments, by a prolongation of its orifice termed the external 
HEARING. 
Fig. 63. 
Internal and external ear. 1. External ear. 2. In- 
ternal auditory meatus. 3. Tympanum. A. Labyrinth. 
5. Eustachian tube. 106 
COMMON SENSE MEDICAL ADVISEE. 
auditory meatus. In man, this half-bony portion of the auditory 
apparatus is about one inch in length, lined by a continuation of 
the integument of the ear, and has numerous hairs on its surface 
to prevent the intrusion of foreign substances. Between the 
external meatus, and the cavity of the middle ear is the mem- 
brana tympani, which is stretched across the opening like the 
head of a drum. The tympanum communicates with the pharynx 
by the eustachian tube, which is a narrow passage lined with 
delicate, ciliated epithelium. On the posterior portion it is con- 
nected with the mastoid cells. Three small bones are stretched 
across the cavity of the tympanum, and called from their formSj 
the malleus, incus and stapes. Agassiz mentions a fourth, which 
he terms the os obiculare. Each wave of sound falling upon the 
membrana tympani, throws its molecules into vibrations and is 
communicated to the chain of bones, which, in turn, impart it to 
the membrane of the foramen ovale. The three muscles which 
regulate the tension of these membranes are termed the tensor 
tympani, laxator tympani, stapedium tympani. 
141. The Labyrinth, or Internal ear, is a complicated cavity, 
consisting of three portions termed the vestibule, cochlea, and 
semi-circular canals. The vestibule is the central portion and 
communicates with the other divisions. The labyrinth is filled 
with a transparent fluid termed perilymph in which are suspended, 
in the vestibules and canals, small membranous sacs, containing 
a fluid substance termed endolymph (sometimes called vitrine 
auditive from its resemblance to the viti’eous humour of the eye). 
The filaments of the auditory nerve penetrate the membranous 
tissues of these sacs and also of those suspended at the com- 
mencement of the semi-circular canals. These little sacs are the 
seat of hearing, and determine in some mysterious manner the 
quality, intensity and pitch of sounds. 
142. The determination of the direction of sound is a problem 
of acoustics. Some have contended that the arrangement of the 
semi-circular canals is in some way connected with this sensation. 
But this supposition, together with the theory of the transmission 
of sound through the various portions of the cranial bones, is 
exploded. 
143. From the foregoing description, it will be seen that the 
labyrinth and tympanum are the essential organs of hearing. SMELL, 
107 
In delicacy, refinement and spirituality this sense ranks next to 
sight. The emotions of beauty and sublimity, excited by the 
warbling of birds and the roll of thunder, are scarcely distin- 
guishable from the intense emotions arising from sight. It is a 
remarkable fact, that the refinement, or cultivation of these senses 
is always found associated. Those nations that furnish the 
best artists, or have the highest appreciation of painting and 
sculpture, produce the skillful musicians — who reduce music 
to a science, the laws of which are the emotions and passions of 
the human soul. 
SMELL. 
3 44. Next in order of delicacy and more closely allied with 
the psychical functions, is 
the sense of smell. Delicate 
perfumes, or the fragrance 
of a flower, impart an ex- 
hilarating sensation of Men 
etre, while nauseous odors 
excite a feeling of disgust. 
In complication of structure, 
the organ of smell is far in- 
ferior to the eye and ear. It 
consists of two cavities hav- 
ing cartilaginous walls, and 
lined with a thick mucous 
membrane, termed the pitui- 
tary membrane, over which 
are reflected the olfactory 
nerves. Particles of matter, 
too minute to be seen 
through the microscope, are 
detached from the odorous 
body and come in contact 
with the nerves of smell, 
which transmit the impres- 
sion, thus received, to the 
brain. For distribution of 
nerves in the nasal passages, 
(see Fig. 64). The nose is 
Fig. 6Jh 
Illustrates the distribution of nerves to the 
nasal passage. 1. Frontal sinus. 2. Nasal 
bone. 3. Olfactory ganglion and nerves. 4. 
Nasal branch of the fifth pair. 5. Spheno-pala- 
tine ganglion. 6. Soft palate. 7. Hard palate. 
Likewise it illustrates a portion of the brain. 
a. Cerebrum, b. Anterior lobes correspond- 
ing to the intellectual faculties, c. Corpus 
callosum. <J. Septum lucidum. /. Fornix. 
g. Tlialami optici. h. Corpora striata. 108 
COMMON SENSE MEDICAL ADVISEE. 
supplied with two kinds of filaments which are termed, re- 
spectively, nerves of special, and nerves.of general sensation. 
Compared with the lower animals, especially those belonging to 
the carnivorous species, the sense of smell in man is feeble. The 
sensation of smell is especially connected with the pleasures and 
necessities of animal life. 
TASTE. 
145. The sense of taste is directly connected with the preser- 
vation and nutrition of the body. A delicious flavor produces a 
desire for the savored substance, as food. Some writers on 
hygiene, have given this sense an instinctive character, by assum- 
ing that all articles, having an agreeable taste, are suitable for 
diet. Dr. Dalton defines the organ of taste to be “ a mucous 
membrane beset with vascular, and nervous papillae similar to 
those of the general integument.” He localizes the sense 
of taste in “ the mucous membrane of the tongue, palate and 
fauces.” The nerves of taste are distributed over these sur- 
faces, and their minute extremities terminate in well developed 
papillae. These papillae are divided into three classes, termed, 
from their microscopic appearance, filiform, fungiform and 
circumv dilate. 
146. The conditions necessary to taste are, (1), that the sub- 
stance be in solution either by artificial means, or, the action of 
the saliva; (2), that it be brought in contact with the sensitive 
filaments, imbedded in the mucous membrane. The nerves of 
taste are both general and special in their functions. If the 
general sensibility of the nerves of taste be unduly excited, the 
function of special sensibility is lost for some time. If a pepper- 
mint lozenge be taken into the mouth, it strongly excites the 
general sensibilities of taste, and the power of distinguishing 
between special flavors is lost for a few moments. A nauseous 
drug may then be swallowed without experiencing any disagree- 
able taste. 
147. Pai’alysis of the facial nerve produces a marked effect in 
the sensibility of the tongue. Wherein this influences life, is 
not fully explained; probably it is indirect, producing some 
alteration in the vascularity of the parts, or a diminution of the 
salivary secretions. TOUCH 
109 
TOUCH. 
148. By the sense of touch we mean the general sensibility 
of the shin. Sensations of heat and cold are familiar illustrations 
of this faculty. By the sense of touch we obtain a knowledge 
of the essential qualities of a body such as form, consistency, a 
rough or smooth surface, etc. The tip of the tongue (according 
to Dr. Dalton) possesses the most acute sensibility of any portion 
of the body and next in order are the tips of the fingers. The 
hands are the principal organs of tactile sensation. The nerves 
of general sensibility are distiibuted to every part of the cuta- 
neous tissue. The contact of a foreign body with the back, will 
produce the same tactile sensation, as with the tips of the fingers. 
The sensation may differ in degree on account of an unequal 
development of the nervous filaments; in quality it is the same. CHAPTER XIV. 
CEREBRAL PHYSIOLOGY. 
149. By means of the nervous system, an intimate relation is 
sustained between mind and body, for nervous energy superin- 
tends the functions of both. The interpenetrating fibres of 
nervous matter are universally present in the organization to 
unite the physical and spiritual elements of man’s constitution. 
Even the minutest nerve-rootlets convey impressions to the 
dome of thought and influence the process of Intellection. We 
recognize muscular force—the momentum of the body, mole- 
cular force—molecules in motion, as heat, light,.chemical force, 
electricity, and nervous force—a certain influence which reacts 
between the animal processes and the cerebrum, thus connecting 
the conditions of the body with those of the mind. We can- 
not speak of the effects of mind or body, separately, but wTe 
may consider their action and reaction upon each other, for 
they are always associated. There are many difficulties attend- 
ing this relationship, some of which may be obviated by 
considering the development of nervous matter and its functions 
in the lower orders of organization. 
150. Within the plant-cells is found a vital, vegetable sub- 
stance termed protoplasm, which exerts the same nutritive power 
as the tissues of the polyp and jelly fish. Many families of 
animals present an appearance of pulp, have slight instinctive 
motion and sensibility, and according as the nervous system is 
developed, both of these powers are unfolded. Plants have a low 
degree of sensibility, limited motion, respiratory and cii'culatory 
organs. Animals possess quicker perceptions and sensibilities, 
the power of voluntary motion, and likewise a rudimental nervous 
system. Some articulates have no skeleton, their muscles being CEREBRAL PHYSIOLOGY. 
111 
attached to the skin which constitutes a soft contracting envelope. 
One of the simplest forms of animal life in which a nervous system 
is found, is the five-rayed star-fish. In each ray or arm there are 
filaments which connect with sim- 
ilar nerves, and form a circle 
around the digestive cavity. It 
probably has no conscious per- 
ception and its movements do 
not necessarily indicate sensa- 
tion or volition. In some worms 
a rudimentary nervous system is 
sparingly distributed to the cavi- 
ties of the thorax and abdomen, 
and, as in the star-fish, the largest 
nerve-filament is found around 
the esophagus, presiding like a 
goddess over nutrition. 
151. A higher grade of organization requires a more complete 
arrangement of nervous substance. Stimulus applied to one 
organ is readily communicated to, and excites activity in another. 
The nervous system of 
some insects consists of two, 
long, white cords, which 
run longitudinally through 
the abdomen and are di- 
lated at intervals into 
knots, consisting of a col- 
lection of nerve-cells, called 
ganglia. They are really 
nerve-centers,which receive 
and transmit impulses, orig- 
inate and impart nervous 
influence according to the nature of their organic surroundings. 
The ganglia situated over the esophagus of insects, correspond 
to the medulla oblongata in man, 118, 119, 120), in which 
originate the spinal accessory, glosso-pharyngeal and pneumo- 
gastric nerves, The latter possesses double endowments 
and not only participates in the operations of deglutition, diges- 
tion, circulation and respiration, but is also a nerve of sensation 
Fig. 65. 
Fig. 66. 
A. Nervous system of a Crab, showing its 
ganglions. B. The nervous system of a Cater- 
pillar. 112 
COMMON SENSE MEDICAL ADVISEE. 
and instinctive motion. The suspension of respiration produces 
the painful sense of suffocation. In insects, these ganglia are 
scarcely any larger than those distributed within the abdomen, 
with which they connect by means of minute, nervous filaments. 
Insects are nimble in their movements and manifest instinct, 
corresponding to the perfection of their muscular and nervous 
systems. If we ascend to vertebrates, (animals having a back 
bone, containing a spinal nervous system) the nervous substance 
is augmented, the organic and voluntary processes are more 
complex, and the automatic actions begin to display intelligence. 
152. Man possesses not only a complete sympathetic system, 
the rudiments of which are found in worms and insects, and a com- 
plete spinal system, less perfectly displayed in fishes, birds and 
quadrupeds, but, superadded to all these is a magnificent cere- 
brum— the special organ of mind. Within the cavity of the 
cranium are the cerebrum, cerebellum and medulla oblongata, 
“ a double series of nervous ganglia connected with each other 
and with the spinal cord by transverse and longitudinal commis- 
sures,” which instantly and consentaneously blend all functions 
into unity. Thus the brain is universally present throughout the 
body. The intermingling nerve-rootlets complete this continuity 
and pervade all parts with its ubiquitous influences. The subtle 
play of motor and reflex impulses, of sentient and spiritual forces 
indicates a perfection of nervous endowments nowhere paralleled, 
and barely approached by inferior animals. This meager reference 
to brainless animals whose knots of ganglia throughout their 
bodies act automatically, as little brains, shows that instinct arises 
simultaneously with the development of the functions over which 
it presides. Here begins rudimentary, unreasoning intelligence. 
It originates within the body as an inward, vital impulse, is mani- 
fested in one undeviating manner, and therefore displays no 
intention or discretion. While Dr. Carpenter likens the human 
organism “ to a keyed instrument, from which any music it is 
capable of producing can be called forth at the will of the per- 
former,” he compares “ a bee or any other insect to a barrel 
organ, which plays with the greatest exactness a certain number 
of tunes that are set upon it, but can do nothing else.” Instinct 
cannot learn from experience, nor improve by practice. But it 
seems to be the prophetic germ of a higher intelligence. It is CEREBRAL PHYSIOLOGY. 
113 
nearly as difficult to divide between instinct and a low grade of 
intelligence, as to distinguish between the psychical and psycho- 
logical * functions of the brain. 
153. The intimate relation of instinct to intelligence is ad- 
mirably illustrated by the working honey-bee. With forethought 
it selects a habitation, constructs comb, collects honey, provides 
a cell for its young, covers the chrysalis, for which it deposits 
special nourishment, feeds the maggots and is disposed to defend 
its possessions. It is a social insect, prefers a colonial government 
and the reign of a queen, chastises trespassers, fights its enemies 
and defends its home. It manifests a degree of intelligence and 
its sagacity is unerring instinct, lieason, though not so acute 
as instinct, becomes, by education, discerning and keenly pene- 
trative, and reveals the very secrets of profound thought. We 
recall the aptness of Prof. Agassiz’s remark: “There is even a 
certain antagonism between instinct and intelligence, so that in- 
stinct loses its force and peculiar characteristics, whenever 
intelligence becomes developed.” Animals, having larger reason- 
ing powers, manifest less instinct, and some, as the leopard, 
exercise both in a limited degree. This double endowment, by 
instinctive, and low reasoning intelligence, is indicated by his 
lying in ambush awaiting his prey, the hiding place being 
selected near the haunt of other animals, where nature offers 
some allurement to gratify the appetite. 
154. Simple reflex action is an instinctive expression, mani- 
festing an intuitive perception, almost intelligent, as shown by 
the contraction of the stomach upon the food, simply because it 
impinges upon the inner coats, and thus excites them to action. 
A better illustration — because it displays sympathy—is when 
the skin, disabled by cold, cannot act and its duties are largely 
performed by the kidneys. Though reflex action (instinctive 
faculties) is easily traced in the lower, organic processes, some 
writers have placed it on a level with rational deliberation. 
* In the use of the terms psychical ancl psychological, we have observed the dis- 
tinction which metaphysicians have recently made. They employ the term 
psychical, as indicating the relation of the human sold to sense, appetite,propensity, 
etc., and psychological, as indicating the ultimates of spiritual being. In this manner, 
we use the word psychical as describing the relationship of the soul to animal expe- 
riences and being, and psychological as referring to the spiritual potencies of the soul. 
The distinction being introduced, we continue its use, rather than coin new words. 114 
COMMON SENSE MEDICAL ADVISER. 
Undoubtedly all animals, having perception, have also what per- 
ception implies — consciousness—and this indicates the posses- 
sion, in some degree, of reason. Compound reflex action extends 
into the domain of thought. Simple reflex action, or instinct, 
answers to the animal faculties, such as acquisitiveness, secre- 
tiveness, selfishness, reproduction, etc., and accomplishes two 
important purposes, viz: self-preservation and the preservation 
of the species. With many persons, these appear to be the chief 
ends of life! 
155. The psychical functions connect, not only with animal 
propensities, but also, with the highest psychological faculties. 
Instinct is the representative of animal conditions, just as the 
highest, spiritual faculties are indicative of qualities and princi- 
ples. The consistent mean of conduct is an equilibrium between 
these ultimate tendencies of our being. The psychological 
functions render the animal nature subservient to the rule of 
purity and holiness, and deeply influence it by the essential 
elements of spiritual existence. The psychical organs sustain an 
intermediate relation, receiving the impressions of the bodily 
propensities, and likewise, of the highest emotions. Obviously, 
these extreme influences,—the one growing out of animal condi- 
tions, the other, the result of spiritual relations,—pass into the 
psychical medium and are refracted by it, or made equivalent to 
one force. The body requires the qualifying influences of spirit. 
The tendencies of the animal faculties are selfish and limiting, 
those of the emotive, general, universal. The propensities, like 
gravity, expend their forces upon matter; the emotions pour 
forth torrents of feeling and produce rhapsodies of sentiment. 
The propensities naturally restrict their expression to a specific 
object of sense, the emotions respond to immaterial being. The 
tendencies of the former are acquisitive, selfish, gratifying; of 
the latter, bestowing, expanding, diffusing. The one class is 
restricted to the orbits of time and matter, the other, flows on 
through the limitless cycles of infinity and immortality. The 
former is satiated in animal gratification, the latter, in spiritual 
beatification. The one culminates in animal enjoyment, the 
other, expands to its ultimate conceptions in the perfections of 
Divine Love, and hallows it with devotion. 
15G. In the present life, mind and body are uniquely blended CEREBRAL PHYSIOLOGY. 
115 
by nervous matter. In this dual constitution, the spiritual, 
mental and animal functions are made inseparable and modify 
each other. The ultimate tendencies, of each extreme, exist, not 
absolutely for themselves, but for qualifying purposes, to estab- 
lish a basis for the deeper economy of life. By the enqfloyment 
of reason, animal and spiritual experiences are mutually benefited 
and the consciousness rendered accountable. The bodily and 
mental workings are in many senses one, and help to interpret 
each other. 
Every fact of mind lias many aspects. A brain force, which 
results in thought, is simultaneously a physiological force, if it 
influence the bodily functions. Likewise, spiritual conceptions 
take their rise in the same blood that feeds the grosser tissues. 
This vital fluid is momentarily imparting, and receiving elements 
from all the bodily organs, and these in turn must influence the 
process of thought, and in a degree, determine its quality. The 
delicate outline, yea, even the substance of an idea, may depend 
upon the condition of the animal organs. Thought is subject to 
the laws of biology, and therefore, is a symbol of health. Morbid 
conditions of the system hang out their signs in words and utter- 
ances. Words, which express fear, are as true symptoms of 
functional difficulty, as is excessive palpitation. The organ, repre- 
senting Fear, sustains a special relation to the functions of the 
heart, both in health and disease. Bright hopes characterize 
pulmonary complaints, as certainly as cough. Exquisite suscep- 
tibility of mind indicates equally extreme sensibility of body, and 
those persons, capable of fully expressing the highest emotions, are 
especially susceptible to bodily sensations. Tears are physical 
emblems of grief, and fellow-feeling calls forth sympathetic tears. 
Excessive anxiety of mind produces general excitability of body, 
which soon results in chronic diseases. Pleasurable emotions 
stimidate the processes of nutrition, and are restorative. This 
concomitance, of mental and bodily states, is very remark- 
able. Joy and love, as well as jealousy and anger, flash in 
the eye and mould the features to their expression. Grief excites 
the lachrymal, and rage, the salivary glands. Shame reddens the 
ears, drops the eyelids and flushes the face; but profligacy 
destroys these expressions. The blush, that suffuses the fore- 
head of the bashful maiden, betrays her love, and maternal love, 116 
COMMON SENSE MEDICAL ADVISER. 
stirred by the appeals of an idol babe, excites the mammary 
gland to the secretion of milk. The sigh of melancholy indicates 
hepatic torpor, thus showing a special relation between the liver 
and respiratory organs. These conditions of mind and body 
react upon each other. Even the representative power of the 
imagination may produce the idea of a luscious peach, and cause 
the mouth to water. The thought of tasting a lemon fills the 
mouth with secretions, and a story, with unsavory associations, 
will completely turn the stomach. 
The relationship of mental and physical functions may be 
illustrated by entirely removing the spleen of an animal, as of a 
dog or cat. One uniform effect, of its extirpation, is an unusual 
increase of the appetite, for at times the animal will eat vora- 
ciously any kind of food. The dog will devour, with avidity, the 
warm entrails of recently killed animals, and thrive in consequence 
of such an appetite. Another symptom, which usually follows 
the removal of the spleen, is an unnatural ferocity of disposition. 
Without any apparent provocation, the animal will attack those 
of its own, or of a different species. In some instances, these 
outbursts of irritability and violence are only occasional, but 
the experiments show quite conclusively, that the spleen moder- 
ates combativeness, restrains appetite, and co-operates with will 
and judgment in controlling them. 
157. We shall briefly consider the practical question, viz: can 
the elements of mind be ideally arranged and represented, so as 
to more completely reveal their relations to, and disclose their 
effects upon the bodily functions? Modern philosophers conceive 
that mind consists of a trinity of essentials,— Intellect, Emotion 
and Volition. Physiologists assign to the cerebrum its func- 
tions, and neurological, as well as phrenological writers have 
located them as represented in Fig. 67. True, there is no struc- 
tural division between the parts of the cerebrum, to indicate this 
diversity of function, nor is there any discoverable limit between 
the sensory and motory filaments of the same nerve. As no one 
has any reason for denying that separate portions of the brain 
may manifest distinct functions of the mind, we shall assume it 
as a conceded proposition. The regions of the cerebrum, thus 
ideally represented, describe but little more than half of the arc 
of a circle, whereas, it is evident that the base of the nervous CEREBRAL PHYSIOLOGY. 
117 
mass is not idle, and is equally entitled to our consideration. In 
the posterior chamber of the 
skull is the cerebellum, ante- 
rior to which is the medulla 
oblongata connecting with the 
spinal cord and sympathetic 
system. These various parts 
are essential to the harmoni- 
ous blending of mind and 
body. To this end, two con- 
ditions are necessary. (1.) 
All the nervous forces must 
be so related, that action and 
reaction may be fully estab- 
lished. (2.) A complete ner- 
vous circuit is requisite for 
the reciprocal influence of mind and body. 
158. Nature answers to mind in physical correspondencies. 
The planetary system, a grain of sand, even the ultimate mole- 
cule, is fashioned after a circle. Life itself springs from a 
spherule of forces. The perfection of an idea or the complete- 
ness of a conception is expressed by a circle. The elements of 
Science, Astronomy, Geology and Natural History are pictorially 
represented in this manner. How appropriately and logically can 
a fragment of natural history, this epitome of all nature and 
science — the mind,—be illustrated by a simple circle! Every 
element must act and react, and be equal and opposite. Thus 
may the existence of the opposing energies and functions of each 
faculty be equally represented. The contrast aids us in under- 
standing their ultimate ten- 
dencies and enables us to 
correctly value and define 
their nature. Faculties of 
kindred qualities may be 
grouped together, and their 
antagonisms represented in 
the opposite arc of the circle. 
Let us employ a circle to 
represent mind. The concept 
Fig. 67. 
Fig. 68. 118 
COMMON SENSE MEDICAL ADVISER. 
of the abstract quality of good, requires contrast with one of an 
obverse nature dad, (see Fig. 68). Opposite faculties may be 
portrayed in the same manner. The functions of the cerebrum 
and spinal system may be symbolically represented, as those of 
the highest and lowest organs, thus giving rise to the positive 
and negative ultimates of feeling. The author conceives of no 
other way by which the widely contrasted facts of human ex- 
perience can be so perfectly symbolized. Good, (Fig. 68,) may 
represent moral faculties, and bad, their opposites. Undoubtedly 
nature is not so arbitrary in her arrangements as we are in shad- 
owing forth our imperfect conceptions, yet is not this a decided 
improvement in determining cerebral faculties, and their rela- 
tions? We observe how scholars and philosophers confound the 
noblest and most exhalted emotions with the animal propensities 
instead of distinguishing between them. “ The emotions are a 
department of the feelings, formed by the intervention of intel- 
lectual processes. Several of them are so characteristic that they 
can be Jcnoion only by individual experiences; as Wonder, Fear, 
Love, Anger.” See Logic: Deductive and Inductive, by Alex- 
ander Bain, LL. D., page 508, (1874). 
This is not an exceptional, but a common example of classify- 
ing Love,—the highest and purest of the emotions,—with Anger, 
—an antipathic, animal propensity. Is it not more practical and 
philosophical to group the emotive faculties together, and upon 
an opposite arc represent their antagonistic energies, the ultimate 
tendencies of which are criminal? Both groups are mutually 
modifying and restraining; the one relates instinctively to the 
bodily wants, the other to the requirements of mind, and each is 
essential to a consistent life. Accordingly, we deem it philo- 
sophical to consider words as symbols of mental faculties and 
classify together such spiritual unities as joy, hope, faith and 
love, the tendencies of which are to quicken and transform the 
ultimates of carnal life into the rudiments of an immortal one — 
the beginning of heaven on earth. These restrain those oppo- 
sites, which lead to crime and death. Love and Hate are as 
antagonistic as heat and cold, and the usefulness of both 
depends upon their proper temperament. Fig. 69 represents the 
antagonism of the Intellectual faculties to the Animal, the Emo- 
tional to the Criminal, the Yolitive to the Enfeebling. It is not CEREBRAL PHYSIOLOGY. 
119 
essential to discover in the nerve-substance the precise focus from 
which an impulse originates. We 
may reasonably interpret the 
functions of the brain, and yet be 
unable to disclose the duties of 
any single nerve-fibre composing 
it. For the size of these filaments 
see 107. We may foretell what 
each season of the year will bring 
forth, when we cannot forecast 
the history of a blade of grass 
or a single grain of any kind. 
We may predict the amount of 
rain for a month and be unable 
to prognosticate, correctly, the 
character of any storm, or give 
the history of a special drop of water. Although we cannot 
follow the movements of individuals in a battle, yet we may 
predict the result of the combat; and thus, we judge of the 
functions of the brain without the ability to reveal the actions 
of one of the organic molecules of which it is composed. We 
aim to make a general, reasonable and popular presentation of 
cerebral functions and their bearing upon health and disease, 
as more extended researches and investigations will be made by 
Drs. Buchanan, Flint, Brown-Sequard, Hammond, Wilder and 
others, who are endeavoring to unfold these wonderful powers. 
Fig. 69. 
REGIONAL DIVISIONS. 
159. The anterior portion of the cerebrum is devoted to 
intellectual processes, which freely expend the vital energies. 
The Intellectual faculties are classified as represented in Fig. 70. 
The lower portion of the brain, bounded exteriorly by the super- 
cilliary ridge, corresponds to the Perceptive, the middle region 
to the Recollective and the upper to the Reflective faculties. (See 
also Fig. 64, b.) If we divide the forehead by three vertical 
lines, they represent, respectively, the Active, Deliberative and 
Contemplative departments of the intellect, all the processes of 
which are sustained by vital changes—the transformation of or- 
ganized materials. No mental manifestation can be made without 120 
COMMON SENSE MEDICAL ADVISER. 
it. Every thought implies waste as well as transition of brain-sub- 
stance. The gard- 
ner’s hoe wears by 
use, and so does 
every member of 
the animal organ- 
ism. Otherwise, 
nutrition would be 
unnecessary for 
the adult. The 
production of 
thought wears 
away the cerebral 
substance. In or- 
d i n a r y use the 
brain requires one-fifth of the blood to support its growth and 
repair. Great mental efforts are attended by a corresponding 
expenditure of vital treasures, which are subtracted from the 
total forces available for the necessities of the system. To repair 
the losses thus occasioned, materials are appropriated from the 
blood, which grants supplies in proportion to the demands made 
by the mental activities. The generation of thought detroys 
the cohesion of the nervous particles and breaks down the cin- 
eritious (ashy) cells of the cerebrum as absolutely as the digging 
of a canal wears away the iron particles of the spade. The brain 
would soon wear out did not the nutritive functions constantly 
replace the destroyed cells. The intellect, whether engaged in 
observation, generalization or in recondite studies consumes the 
brain and blood, hence intellectual activity implies vital expend- 
iture. Expenditure is an emphatic word, because, all functions 
are essential to the production of this nerve-energy, which 
returns to the system no compensating equivalent. Physical 
exercise, although attended by muscular and structural wastes, 
is advantageous to the circulation of the blood, nutrition, secre- 
tion, and in fact beneficial to all the organic processes. This 
is not true of vigorous and prolonged mental labor, which is 
not attended by any of these incidental advantages. If a child 
attend a school in which mental development supercedes physical 
culture, an inordinate ambition sways the youthful mind, and its 
Fig. 70. cerebral physiology. 
121 
baneful effects upon the health soon become manifest. Rigorous 
application of the intellectual faculties consumes the blood, 
absorbs the vital forces, weakens the organic functions while palor 
covers the face, and the eyes sparkle with a hectic radiance. 
The family physician pronounces the condition “ Anaemic ” 
(bloodless) and this diminution in the quantity and quality of 
the blood is owing to the undue appropriation by the intellect 
which transforms it into thought. Contrariwise, if the blood be 
destroyed or its vitality reduced, in the same proportion, will 
the mental energies be weakened and all the functional powers of 
the physical system, enfeebled. In brief, if the intellect be 
unduly exercised, the red corpuscles of the sanguine fluid will 
be gradually destroyed, and the serum allowed to predominate. 
The blood becomes weak and watery, the subject is nervous, 
dropsical, consumptive, and a derangement of the important 
functions will follow in the train of debility. Excessive intel- 
lection results in an adynamic (weak) state of the system, and 
the person thus affected becomes languid, spiritless and an easy 
prey to disease. This mental cause and its bodily results may 
be classified in the following order. Mental Cause: Excessive 
Intellection, which produces icaste of the brain substance and 
blood. 
Vital Expenditure. 
Anaemia. 
Adynamic Condition. 
Bodily results: 
This kind of waste is best summed up in the words, Vital 
Expenditure. Upon the forehead, as represented in Fig. V1, 
we will therefore inscribe Intellect, Activity and Vital 
Expenditure. Intellectual employment is usually accompa- 
nied by sedentary habits, neglect of healthful exercise and a 
deprivation of pure air, to all of which, ill health may be 
attributed. Were the intellectual expenditure stopped, and 
the forces turned into recuperative channels, many a person 
would become beautiful in the ruddy glow of health. With- 
out health there is no use for thought; the cultivation of the 
mind is just as natural and essential, as the culture of the 
body, and the trained development of both is needed for mutual 
improvement. COMMON SENSE MEDICAL ADVISER. 
EMOTIVE FACULTIES. 
160. What results follow the natural and excessive exercise 
of the Emotive Faculties? As distinct organs of the body 
Fig. 71. 
have diverse functions, in like manner, different parts of the brain 
perform the separate operations of the mind. It is easier to dis- 
criminate between the products of these unlike endowments, than 
to determine the location of the faculties. The intellect deals 
with concretes, the emotions with abstractions; the intellect is 
exercised with things, the emotions dwell upon attributes; the 
intellect considers the forces of matter, the emotions, the powers CEREBRAL PHYSIOLOGY. 
123 
of the soul; the former deliberates upon the truths of science, 
the latter, reflect upon duties, obligations, or moral responsibili- 
ties; the first is satisfied only with new truths, original ideas and 
rational changes, the last rest securely in fundamental princi- 
ples, moral certainties and the absolute constancy of perfect love. 
The intellectual faculties are wakeful, questioning, mistrustful; 
the emotions are blind, hopeful, confiding; the one reasoning, 
exacting, demonstrating; the other, believing, inspiring, devout. 
The intellect sees, the emotions feel,—“ in the Thought is the fall; 
in the Heart the atonement;” and though these functions may 
blend, the one can never supersede the other. 
161. The quality of the emotional faculties is represented by 
Benevolence, Sympathy, Joy, Hope, Confidence, Gratitude, Love 
and Devotion, all of which are the very antitheses of the expres- 
sions of animal feeling described as Melancholy, Fear, Anger, 
Hate, Malevolence and Despair. To the emotions we refer the 
highest qualities of character; while their opposites represent the 
animal or baser impulses. True, the emotions modify the pro- 
pensities as sympathy softens grief. They may subdue and 
refine the animal feelings and thus veil them with a delicacy 
characteristic of their own purity; but the unrestrained im- 
pulses of grief find vent in loud lamentations, and the bitter 
disappointments of the selfish faculties are passionate and violent. 
162. The Emotive Faculties — the organs of spiritual per- 
ceptions—are impersonal, outflowing, bestowing. The function 
represented by Benevolence is willing, giving. Devotion expresses 
dedication, consecration; Gratitude manifests a warm and friendly 
feeling toward a benefactor. 
“The depth Immense of endless gratitude.”—Milton. 
Love flames toward its object, is out-pouring, blessing; indeed, 
all the emotions are gushing, effusive, impetuous and profusely 
flowing; grand, torrent-like, overwhelming; employing ideal, 
immaterial, spiritual expressions, evolving principles and per- 
fections while feeling for happiness and immortality. Though 
beginning with humanity, they embody the Divine. They 
expand to their ultimate conceptions in the sublime attributes,—- 
the perfections of the God of Love; associating with mortality 
a divine destiny commencing on earth, augmenting through time, 124 
COMMON SENSE MEDICAL ADVISER. 
pausing not at the portals of death — the gateway to eternity 
— but flowing onward through realms of eternal day. 
163. We may consider their counter-vailing influences, for 
without doubt, by checking the selfish tendencies, restraining the 
animal propensities, they assist in controlling the sensual desires 
and thus balance the mind and body. They tend to quiet the 
storms of passion, lull turbulence and produce consistency of 
conduct. Such an equilibrium we call happiness. If the emo- 
tions be acute and vehement, they will absorb all other impres- 
sions and revel in their sharply culminating and delightful 
experiences. They exhaust all the bodily energies and a func- 
tional suspension, termed ecstacy, must follow. It is a swooning, 
or fainting, a temporary loss of sensation and volition, accom- 
panied by involuntary movements of the arms, smiting of the 
hands, sighing and short ejaculatory expi-essions of rapture. 
This condition, occasioned by excessive emotion, as in praying, 
singing, exhortations and sympathetic appeals, is contagious, 
often spreading with mysterious celerity. Its culmination — 
ecstacy — is popularly termed uthe power” When gradually 
induced it is called trance, and either state is regarded by many 
as supernatural, caused by the immediate operation of the Holy 
Spirit. The explanation is simply this: the emotive faculties are 
deprivative; when suddenly and powerfully excited, they 
quickly expend the organic energies, so that the individual 
swoons from sheer exhaustion. Undue expenditure of this class 
of brain functions, not only consumes the bodily powers, but 
exhausts and destroys other mental operations. The sudden col- 
lapse of all the voluntary functions resembles syncope (fainting) 
produced by blood-letting. We may sum up this rapid expen- 
diture of energy in one expressive word,— Exhaustion, which 
results in Ecstacy, or trance, and if carried a degree farther, will 
terminate in mortality. Beginning with the natural exercise of 
the emotions, we may state the order of sequences thus: 
Ordinary exercise leads to . • . . Calmness. 
Proper exercise “ “ .... Happiness. 
Increased exercise “ “ . . . . Ecstasy. 
Excessive exercise “ “ . . . . Syncope. 
Prolonged exercise “ “ . . . . Trance. 
Fatal exercise “ “ . . . . Mortality. 
Their tendencies are EXHAUSTIVE. CEBEBKAL PHYSIOLOGY. 
125 
VOLITIYE FACULTIES. 
What are the pSycho-physiological and morbid results at- 
tending the ordinary and immoderate exercise of the Volitiye 
Faculties ? 
164. The generic term will, comprehends those faculties, the 
action of which is termed volition. The faculties of the will are 
Determination, Firmness, Decision, Ambition, Authority and 
Vigilance,- all of which indicate strength and continuity of pur- 
pose. Bordering upon the emotions are Patience and Persever- 
ance, while adjoining the animal faculties are Power, Coarseness 
and Love of Display. The former exhibit moral, the latter 
animal heroism. A sense of power urges forward, whether 
it be higher or lower, just as the sense of greatness makes a man 
great by inspiring him with confidence to put forth exertion. 
Nature is truthful in her inspirations. We know that courage, 
assurance and conscious power are necessary for the fulfillment 
of purpose, because intention precedes action. Will-power is a 
synonym of Health, and the constant exercise of these psychical 
faculties exert a steady, regular and energizing influence upon 
the bodily functions. We translate psychical energies as physio- 
logical industry. These faculties impart tone to the system, 
sustain the processes of nutrition, circulation, assimilation, secre- 
tion, excretion, and express vigor, tension and elasticity as their 
distinguishing characteristics. They temper each element of 
character as well as every vital act. They infuse the organism 
with a resisting power which renders it impervious to the influ- 
ence of miasms and malaria, and overcomes that passivity and 
impressibility, so favorable to disease. Firmness expresses a 
physiological cohesiveness which strongly binds together the 
fibres of the tissues, and renders the organization compact and 
powerful. He, who can artfully employ these energies, is already 
master of one-half of the diseases incident to mankind and wields 
an indispensable complement of medicine, in the successful prac- 
tice of the healing art. It is the key to success, for it unlocks 
difficulties and opens wide the door,which leads to fortunate issues. 
Surplus energy sustains the circulation, increases capillary 
action, as though the excess of neural power were discharged 
from the distant extremity of each nerve and pervaded every 126 
COMMON SENSE MEDICAL ADVISER. 
tissue. The voluntary muscles indicate their participation in 
this energy, and indeed, the whole organism is exalted by the in- 
fluence of the volitive faculties. They oppose the tendencies of 
Feebleness, Relaxation, Derangement and modify their proclivi- 
ties to Disease. The will is the servant of the intellect, emotions 
and propensities, and the executive agent of all the faculties. 
When the volitive faculties are in excess they may overdo the 
other functions, prematurely break down the bodily organs, and 
by overtaxing the system, subject it to pain and disorder. 
Briefly, the tendencies of these faculties may be stated as follows: 
The natural effect of Firmness is stability (physiological). 
The exercise of the volitive faculties displays both mental and 
bodily Energy. 
VOLITIVE FA C UL TIES. 
Temperance, 
Sanity and 
Health. 
Their tendencies are to 
ANIMAL FACULTIES. 
Under tliis generic term we will group those cerebral powers 
which are common to inferior animals, and closely allied to 
bodily conditions and necessities. As denoting a group of ani- 
mal faculties they relate not only to the organic functions and 
self-preservation, but antagonize the action of the intellect, 
Fig. 72. 
Fig. 78. 
Fig. 72 is a representation of the cerebral conformation of Alexander VI., exhib- 
iting a full development of the conservative faculties, and whose character, according 
to history, brought reproach upon the papal chair. 
Fig. 73 represents Zeno, a profound thinker and moral philosopher. The contrast 
iu their cranial developments is no greater than in their lives. CEREBRAL PHYSIOLOGY. 
127 
oppose the evolution of new ideas, check investigation and 
discredit the value of truth. Adhesiveness clings to old 
ideas and is in league with traditionary opinions, being blindly 
conservative. The animal faculties tend to stifle investigation 
and put authority above truth or science. Having a fixity of 
nature — a stationary attachment — they treat all intellectual 
developments as absurd. When these faculties bear sway, 
thought is obscured, intolerance of disposition is manifested and 
mental progress arrested. Thus they evince their conservative 
nature and since they relate to individual interests they represent 
the elements of instinct. Such are the functions of Acquisitive- 
ness, Secretiveness, Selfishness and Combativeness as well as the 
Generative powers. If these faculties predominate, all intellect- 
ual advances are treated as experiments or theoretical novelties, 
and rejected as evanescent and worthless. If the promptings 
of these be followed, there will be no innovation, and the ortho- 
doxy of the dark ages remains the standard for time. As the 
honey-bee once constructed its cell, so it will always, and simi- 
larly would stubborn Adhesiveness restrict all other facidties to 
its own narrow province. The animal faculties coincide with 
Lethargy, Sleep and Nutrition, thus favoring organic restoration. 
The intellectual faculties are wakeful, active, irrepressible, while 
the animal powers tend to repose, sleep and renovation and thus 
suspend the activities of thought, sense and motion. The intel- 
lect when absorbed in deep studies, disregards time, but the animal 
faculties observe periodic intervals of activity and repose. The 
intellect expends the energy of the sensorial centers, induces 
fatigue and suffering, whereas, the animal faculties overcome the 
vigils of thought, and produce refreshing slumber. Dr. Young 
styles sleep, as, “ tired nature’s sweet restorer,” and Dr. Alex- 
ander Wilder speaks of it, as, “our favorite panacea for ail- 
ments.” Swedenborg declared that “ in sleep the brain folded 
itself up, and the soul journeyed through the body, repairing the 
wastes of the previous day.” When sleep is natural, the insane 
are in a fair way of recovery, the sick become convalescent, 
ulcers granulate and lesions are made whole. 
The animal faculties are skeptical, stubborn and dogmatic, 
readily combining with those of the violent class, the ultimate 
tendencies of which are criminal. They are likewise conceited, 128 
COMMON SENSE MEDICAL ADVISER. 
assuming and clannish. Any person distinguished by them, will 
cling to old associations, perpetuate the status of existing parties, 
be a stickler for creed, ceremonies and hoary opinions, and ad- 
here to ancient orthodoxy in medicine and religion. The animal 
faculties, since they are staid, regular and devoted to habit, 
naturally antagonize genius, sensibility and originality. Their 
mental tendencies have been fairly referred to, and their physio- 
logical results may be represented as follows: 
Restraint, 
Sleep, 
N UTRITION, 
Restoration, 
Conservation. 
The animal faculties produce 
165. The ultimate tendencies of the faculties, represented by 
the posterior base of the cerebrum, are violent and criminal. 
Being contiguous to the junction of the cerebrum and spinal 
system, they are subject to the influence of animal experiences. 
A large development of these faculties is indicated by an unusual 
breadth and depth of the occipital base of the brain, and a full, 
thick neck, both of which denote good alimentative and diges- 
tive powers. Active nutrition, plethora of the circulation, vigor- 
ous secretion, a well developed muscular system, large heart and 
lungs are accessory conditions. We do not associate corpulence, 
or surplus of vitality with a long, slender neck. The character 
of cerebral manifestations is represented by the baser faculties 
of mind, such as Combativeness, Destructiveness, Desperation, 
Turbulence, Hatred and Revenge. If unrestrained, these cul- 
minate in violent and criminal acts; if regulated, they are 
employed in personal defense. When unduly excited, they lead 
to dissipation, obscenity, swearing, rowdyism and licentiousness; 
when perverted, they are the sources of recklessness, quarrels, 
frauds, falsehoods, robberies and homicides. They are un- 
like instinct in that they are not self-limiting. The intimate 
relation which they sustain to the stomach and nutrive func- 
tions, is strikingly displayed in the habit of alcoholic intoxi- 
cation. Spirituous drinks deprave the appetite, derange and 
destroy the stomach, poison the blood, and pervert all the 
BASILAR FACULTIES. CEREBRAL PHYSIOLOGY. 
129 
functions of mind and body; and their injurious influence upon 
the nerves and basilar faculties is equally remarkable. They ex- 
cite combativeness, selfishness, irritability, and exaggerate the 
influence of the animal organs. Intemperance results in dis- 
putes, fights, brawls and murders — the legitimate sequences 
of which are misunderstandings, suits at law, criminal proceed- 
ings, states prison and the gallows. It is, therefore, evident 
that the ultimate tendencies of these faculties are tyranical, 
cruel, violent and atrocious. They antagonize the noble, moral 
faculties — Faith, Love and Devotion — and, whenever temp- 
tation, inordinately allures, the course of life is likely to be 
charracterized by dishonorable, deceptive and treacherous 
conduct. 
166. The pangs of hunger will cause soldiers to act more 
like ravenous beasts, than, rational beings. It is animal instinct 
that directs the soldier to seek first for the gratification of his 
appetite. Some persons impelled by carnivorous desires, yearn 
for raw meat, and cannot be satisfied unless their food is flavored 
with the flesh of animals. Their bodies increase and thrive, 
even to repletion. Contrast these individuals with pale, lean, 
anaemic (bloodless) ones, who crave innutritions articles of diet, 
and eat soft stones, slate, chalk, blue clay and soft coal. Such 
perversions of the appetite are manifest only when there is, 
either a diminution in the volume of blood, deficient alimenta- 
tion, defective assimilation, or a general depravity of the nutri- 
tive functions. Morbid conditions generate vitiating tendencies 
and destroy the natural appetite. 
167. While alcoholic stimulants affect the posterior occipital 
organs, opium intoxicates the semi-intellectual faculties, and 
excites reverie, dreamy ideality, optical illusions and the creative 
powers of the imagination; some of these unnatural representa- 
tions are said to be grotesquely beautiful and enjoyable. The 
effects of this agent differ from those of alcoholic intoxication by 
not deadening the moral sensibilities, or arousing the animal pro- 
pensities. Opium smokers are dreamy and abstract, not quarrel- 
some or violent. Those, who use ardent spirits, lose their moral 
delicacy, the intellect becomes dull, the reason cloudy, and the 
judgement is overruled by appetite. It is conceded that the tro- 
phic center is principally in the medulla oblongata; the cerebellum common sense medical adviser. 
and lower cerebreal ganglia, however, favorably influence the 
nutritive functions, and when these organs are large and active, 
a plethoric condition is the natural consequence.* Redundency 
of blood, in the body, indicates preponderance of the basilar or- 
gans. These faculties being vehement in character, an excess of 
animality produces those conditions which result in acute and in- 
flamatory diseases. We may express these conditions of the 
system as follows: 
Animal Faculties, correspond to the lower instinctive mani- 
festations. 
Acquisitiveness, 
Selfishness, 
Combativeness. 
Elements of character are 
And tend to 
Turbulence, 
Crime. 
Alimentation, 
Secretion, 
N U TUITION, 
Reproduction. 
They relate especially to the 
functions of 
Vitality, 
Plethora, 
HyperjEmia (active 
congestion). 
A large development of them 
indicates 
These naturally give rise to violent diseases which may be 
arranged as follows: 
6 
S 
m 
Inflamation, 
Rheumatism, 
Gout, 
Convulsions, etc. 
Class of diseases 
REGION OF FEEBLENESS 
168. Although the middle lobe of the cerebrum, at the base 
of the brain (see 130), does not denote decided force of 
* Mr. Herbert Spencer regards the Medulla as the seat of all the feelings—the instru- 
ment of those emotions which are intensely painful or pleasurable. We are inclined 
to believe that they originate as encephalic forces, communicated to the medulla, 
which, in turn, modifies and reflects them, since it receives the influences of functional 
changes from the cerebrum above, as well as sensory impressions from the body 
below, and sustains an active relationship between them. We give to this region the 
term of Excitability, where we locate chronic disease. The relation which the 
medulla sustains to painful and pleasurable emotions is undoubtedly the reason that 
Mr. Spencer regards “ the medulla so generally the seat of chronic nervous diseases, 
whether the excess from which they arise be sensational, emotional, or intellectual.” CEREBRAL PHYSIOLOGY. 
131 
character, or energy of constitution, yet it has a certain sphere of 
normal action which is essential to the harmony of mind and 
body. If this region be largely developed, the constitution is 
languid, inefficient, sensitive and abnormally disposed. But if 
it be deficient, the volitive energies prej>onderate, and there 
is a deficiency of those susceptibilities of constitution, which 
prevent excessive waste. The cerebral faculties, belonging to the 
region of feebleness are Fear, Anxiety, Sensibility, Servility, Re- 
laxation and Melancholy, and their excessive predominance indi- 
cates a weak, vacillating, irresolute character, and the existence 
of those bodily conditions which produce general excitability 
and chronic derangement. A full development of this portion 
of the brain indicates that the -pm'S011 is naturally dependent, 
inferior, and a servant to stronger characters. Such an one is 
fearful, fretful, complaining, irritable, dejected, morose and 
sooner or later, becomes a fit subject for chronic disease.* 
The ultimate result of excessive fear, excitability, and irrita- 
bility, is functional, or organic derangement,— the morbid con- 
ditions represented by the word Disease. The medulla oblongata 
and portions of the middle lobe of the brain, the functions 
of which represent, Excitability, Anxiety, Fear and Irritability 
(symbols of physical profligacy), are located just between the 
ears (see Figs. 59 and 71). Inferior animals distinguished for 
breadth between the ears, are not only cunning and treach- 
erous, but very excitable and irritable. The combativeness of 
the dog may be thoroughly aroused by rubbing his ears, and 
under the acute excitement thus produced, he will attack any 
animal. The head of the Fox is remarkable for its extreme 
width at the region of Fear. He is proverbially crafty and 
treacherous, always excitable, and so variable in temper that 
he can never be trusted. He is a very timid thief, exceedingly 
* Certain disturbances of the bodily organs excite fear. The apprehension of 
danger, or simply mental excitement, does not explain what is called “water 
fright,” “stage fright,” terror excited by the raging of a storm, or the rocking of a 
boat. In such instances the heart may beat heavily, the respiration be irregular and 
attended by precordial oppression, giddiness, weakness and physical inability to 
articulate a word or recall a thought. These bodily conditions are not subject to the 
control of the will, but arise when individuals are perfectly assured that no danger 
threatens. At other times, as in a fearful tempestupon the sea, although the danger 
be imminent, if the bodily functions are not disturbed, there is not the least 
manifestation of fear. COMMON SENSE MEDICAL ADVISER. 
suspicious, irregular in habits, and frequently driven by hunger 
into mischievous depredations. 
169. The organ of alimentiveness, 
•—located directly in front of the ear 
•—indicates the functional conditions 
of the stomach, which when aroused by 
excessive hunger, exerts a debasing in- 
fluence upon this and all of the ad- 
jacent organs, and is demoralizing 
to both body and mind. In obe- 
dience to the instinct of hunger, 
children will slyly plunder gardens and 
orchards, displaying profligate, if not reckless tendencies in the 
gratification of the appetite. In this regional division we include 
the medulla, the posterior and middle portions of which give 
rise to the pneumogastric nerve. This nerve receives branches 
from the spinal accessory, facial, hypoglossal, and the anterior 
trunks of the first and second cervical, and its filaments are dis- 
tributed to the lungs, stomach, liver, spleen, pancreas and gall 
bladder (see Fig. 59, with explanation). Its agency is neces- 
sary to maintain digestion, circulation and respiration, since, as 
the medium of communication, it conveys from the brain, large 
supplies of nervous force to sustain these vital functions. It 
likewise, instantly reports the impressions of these physiological 
processes to the brain, and especially to those parts which, by 
analogy of functions, are intimately related to the stomach. 
Ilence, we observe that the conditions of the stomach give rise to 
reflex impulses, which involuntarily arouse the animal faculties 
to the gratification of the appetite. That the stomach belongs 
to the enfeebling organs is evident from the fact that when it 
is inflamed the body is completely prostrated. It appears to be 
a dissipator of energy, as well as the cause of dissipation. 
Fig. 7Jf.. 
Sly Reynard. 
170. We have already alluded to the perverting tendencies 
of alcoholic stimulus. Its peculiar influence upon the cerebel- 
lum causes the subject to reel and stagger, as though a portion 
of that organ were removed (see 129); the group of energetic 
faculties is stupefied, and mental, as well as corporeal lethargy 
is the result. The reaction, which inevitably follows, is almost 
unbearable ond relief is sought by repeating and increasing the 133 
CEREBRAL PHYSIOLOGY. 
poisonous draughts, the primary influence of which is stimulating, 
the ulterior, depressing. Alcoholic stimulus unduly excites the 
nervous centers, the heart and arteries, and, consequently, the 
blood is carried to the surface of the body, where it counteracts 
the influence of cold and exposure — the frequent attendants 
upon inebriety! With certainty does this practice pervert the 
appetite, interrupt habits of industry and destroy all force of 
character! Pecuniary, physical, and mental demoralization, 
therefore, are sure to follow as the sequences of habitual, alcoholic 
intoxication. 
171. That ordinary alimentation—which includes the process 
of digestion, the subsequent vital changes involved in the conver- 
sion of food into blood and its final transformation into tissue, 
—causes mental languor and dulness as well as bodily exhaustion, 
is attested by universal experience. A torpid condition of the 
liver, (one of the most inveterate of chronic derangements,) is in- 
dicated by sullenness, melancholy, despondency, loss of interest 
in the affairs of life, sluggishness, etc., and the ultimate tendency 
of this morbid state is suicide. A broad and deep develop- 
ment of the middle lobe of the brain, shown by a fulness under 
the chin, and of the adjacent portion of the neck, denotes ten- 
dencies to sleep-walking, delirium and insanity. If such char- 
acteristics of the organization do not culminate in mental 
derangement, they exhibit childishness, helplessness and great 
dependence. Age abates the vigor of the executive faculties 
and old people manifest not only bodily infirmities, but the relax- 
ing, and enfeebling influences proceeding from the lower portions 
of the brain. They tottle about in their second childhood, men- 
tally and physically enervated. Those who become dissipated 
by the use of intoxicating beverages, are not only weak, trifling 
and foolish, but walk with an unsteadiness that betrays their 
condition. These illustrations show that this part of the brain is 
void of energy. Diseases of the digestive organs also indicate 
it. Cholera, whether induced by invisible animalcules in the air, 
or water, takes the route of the alimentary canal, opens the vital 
gates, and myriads of victims are swept down to death. It proves 
remarkably fatal to those having this cerebral conformation. 
Perhaps enough has been suggested to indicate the relaxing and 
enfeebling tendencies of this region of the brain, and they may 
be represented as follows: 134 
COMMON SENSE MEDICAL ADVISER. 
REGION OF FEEBLENESS. 
Servility, 
Cautiousness, 
Fear, 
Anxiety, 
Sensibility, 
Cunning, 
Profligacy. 
Cerebral Functions : 
Atonic, 
Excitability, 
Relaxation, 
Feebleness, 
Disease. 
,,, . , . , j.,. 
Physiological conditions 
and tendencies: 
This classification shows the tendencies to chronic disease, 
functional derangement, insanity and suicide. 
GENERAL CONSIDERATIONS. 
172. Before the structure of the brain was understood, Buff on 
spoke of it as a “mucous substance of no great importance.” 
Its functional significance was so slightly appreciated that some 
people hardly suspected they had any brains, unless an accident 
revealed their existence ! Latterly, however, it is generally under- 
stood, that the perfection of an animal depends upon the number, 
and development of the organs controlled by the nervous system, 
the sovereign royalty of which is symbolized by a grand cere- 
brum,—the throne of Reason. That animal, which is so low 
in the scale of organization as to resemble a vegetable, belongs 
to an ascending series ending in man. The lowest species have 
no conscious perception, and their movements do not necessarily 
indicate sensation or volition. Instinct culminates in the Artic- 
ulates— especially in the class of Insecteans; while created 
intelligence reaches its acme in man — the highest representative 
of the Vertebrates. 
“All things by regular degrees arise— 
From mere existence unto life, from life 
To intellectual power; and each degree 
Has its peculiar necessary stamp, 
Cognizable in forms distinct and lines.”—Layater. 
Man, in the faculties of mind, possesses more than a comple- 
ment for instinct; some of the lower animals, however, seem to CEEEBKAL PHYSIOLOGY. 
135 
share his rational nature and, to a certain degree, become respon- 
sible to him. Finally, the manifestations of mind bear a relation 
to the development of cerebral substance, and to the bodily 
organization which supplies the brain with blood. Fig. 75, 
shows the relative sizes 
of brain in the lower 
animals, compared with 
that of man; the pecu- 
liarities of each agree- 
ing with its cerebral 
conformation. It is 
easier to measure the 
capacity of skulls, in 
different races, than to 
procure and weigh their 
brains. The following 
table has been pub- 
lished. 
Fig. 75. 
Outline of Skulls. 1. European. 2. Negro. 3. 
Tiger. 4. Hedge Ilog. 5. Sloth. 
CRANIAL CAPACITY OF HUMAN RACES. 
KACE. CUBIC INCHES. 
Sweedes, 100.00 
Anglo Saxons, 96.00 
Finns, 95.00 
Anglo Americans, 94.30 
Esquimaux, 86.32 
North American Indians, 84.00 
Native Africans, 83.70 
Mexicans, 81.70 
American Negroes, 80.80 
Peruvians and Hottentots, 75.30 
Australians, 75.00 
Gorilla, adult, 34.50 
Idiot, 22.57 
Mr. Davis, of England, having a collection of about eighteen 
hundred cranial specimens, obtained from different quarters of 
the Globe, ascertained the relative volume of brain in different 
races, by filling the skulls with dry sand. He found that the 
European averaged 92 cubic inches, the Oceanic 89, the Asiatic 
88, the African 80, the Australian 81. Dr. Morton, of Philadel- 
phia, had a collection of over one thousand skulls, and his 136 
COMMON SENSE MEDICAL ADVISER. 
conclusions were that the Caucasian brain was the largest, the 
Mongolian next in size, the Malay and American Indian smaller, 
and the Ethiopian smallest of all. The average weight of 
brain, in 278 Europeans, was 49.50 oz., in 24 White Ameri- 
can soldiers, 52.06 oz., indicating a greater average for the 
American brain. 
The brain of Cuvier, the celebrated naturalist, weighed 64.33 
Iiuloff—murderer and linguist, 59.00 
Dr. Spurzheim — phrenologist, 55.06 
Celebrated philologist, 47.99 
Celebrated mineralogist, 43.24 
Upholsterer, 40.91 
OUNCES. 
The weight of the human brain varies from 40 to 60 oz.; that 
of idiots from 12 to 36 and 40 oz. The average of 278 male 
European brains was 49£ oz., while that of 191 females was 44 
oz. If we compare the weight of the female brain with that of 
the body, the ratio is found to be, as 1:36.46, while that of the 
male is, as 1:36.50; showing that, relatively, the female brain is 
the larger. It appears that neither the absolute, nor relative 
size of the cerebrum, but the amount of gray matter, which it 
contains, is the criterion of mental power. Although a large 
cerebrum is generally indicative of more cineritious substance 
than a small one, yet it is ascertained that the gray substance 
depends upon the number, and depth of the convolutions of the 
brain, and the deeper its fissures, the more abundant is this 
dynamic tissue,— so-called because it indicates the power of the 
mind (see 130). It is this subtance which acts consciously, 
while the white portion only receives, and transmits impressions. 
173. Wo do not wish to underrate any attempt, heretofore 
made, to classify the functions of mind and assign to them an 
appropriate nomenclature. It is not unusual for scientists to 
give advice to phrenologists and point out the fallacies of their 
system; hut it is hardly worth while to indulge in destructive 
criticism, unless something better is offered, as the day has 
passed for ridiculing endeavors to understand and interpret 
the physiology of the brain. The all important question is, 
not whether phrenologists have properly located and rightly 
named all the faculties of mind, but have their expositions been CEREBRAL PHYSIOLOGY. 
137 
useful in the development of truth. While endeavoring to con- 
nect each mental power with a local habitation in the brain, the 
system of phrenology may be chargeable with some cross divi- 
sions (incongruous classification of the faculties,) and yet it has 
furnished an analysis of the mind which has been of incalculable 
service to writers upon mental philosophy. Phrenology, in 
popularizing its views, has interested thousands in their own or- 
ganizations and powers, who would otherwise have remained 
indifferent. It has called the attention to mental and bodily 
unities, served as a guide to explain the physical and psychical 
characteristics of individuals, and been instrumental in applying 
physiological and hygienic principles to the habits of life,' thus 
rendering a service for which the world is greatly indebted. 
Samuel George Morton, M. D., whose eminent abilities and 
scholarship are unquestionable, employs the following language: 
174. “The importance of the brain as the seat of the faculties 
of the mind, is pre-eminent in the animal economy. Hence, the 
avidity with which its structure and functions have been studied 
in our time; for, although much remains to be explained, much 
has certainly been accomplished. We have reason to believe, 
not only that the brain is the center of the whole series of men- 
tal manifestations, but that its several parts are so many organs; 
each one of which performs its peculiar and distinctive office. 
But the number, locality, and functions of these several organs 
are far from being determined: nor should this uncertainty sur- 
prise us, when we reflect on the slow and devious process by 
which mankind has arrived at some of the simplest physiological 
truths, and the difficulties that environ all inquiries into the 
nature of the organic functions.” 
175. We may here allude to the recent experimental researches 
with reference to the functions of various portions of the brain, 
prosecuted by Dr. Ferrier, of England. He applied the electric 
current to different parts of the cortical substance of the cerebrum 
in lower animals which had been rendered insensible by chloroform, 
and by it, could call forth muscular actions, expressive of ideas 
and emotions. Thus, in a cat, the application of the electrodes at 
point 2 (Fig. 76), caused elevation of the shoulder and adduction 
of the limb, exactly as when a cat strikes a ball with its paw; 
at point 4, corrugation of the left eye-brow, and the drawing 138 
COMMON SENSE MEDICAL ADVISER. 
inward and downward of the left ear; when applied at point 5, 
the animal exhi- 
bited signs of pain, 
screamed, and 
kicked with both 
hind legs espe- 
cially tho left, at 
the same time 
turned its head 
around and looked 
behind in an as- 
tonished manner; 
at point C, clutch- 
ing movement of 
the left paw, with protrusion of the claws; at point 13, twitching 
backward of the left ear, and rotation of the head to the left and 
slightly upward, as if the animal were listening; at point 17, 
restlessness, opening of the mouth, and long-continued cries as 
if of rage or pain; at a point on the under side of the hemisphere, 
not shown in this figure, the animal started up, threw back its 
head, opened its eyes widely, lashed its tail, panted, screamed 
and spit as if in furious rage; and at point 20, sudden contraction 
of the muscles of the front of the chest and neck, and of the 
depressors (muscles) of the lower jaw, with panting movements. 
The movements of the paws were drawn inward by stimulating 
the region between points 1, 2 and 6; those of the eyelids and 
face were excited between 7 and 8; the side movements of the 
head and ear in the region of points of 9 to 14; and the move- 
ments of the mouth, tongue and jaws, with certain associated 
movements of the neck, being localized in the convolutions 
bordering on the fissure of Sylvius (B), which marks the division 
between the anterior and middle lobes of the cerebrum. Dr. 
Ferrier made similar experiments on dogs, rabbits and monkeys, 
but the details of the latter, we have not seen. The series of ex- 
periments made on the brain of the monkey is said to be the most 
remarkable and interesting, not only because of the variety of 
movements and distinctly expressive character of this animal, but 
on account of the close conformity which the simple arrangement 
of the convolutions of its brain bears to their more complex 
Fig. 76. 
Side view of brain of a Cat. A. Crucial sulcus dividing 
anterior convolutions, if. Fissure of Sylvius. C. Olfactory 
bulb. CEREBRAL PHYSIOLOGY. 
139 
disposition in the human cerebrum. It is premature to say what 
import we shall attach to these experiments, but they have 
established the correctness of the doctrine, advanced in •([ 131, 
that thought,—the product of cerebral functions,—is a class 
of reflex actions. The cerebrum is not only the source of ideas, 
but also of those co-ordinated movements which correspond to 
and accompany these ideas. Certain cerebral changes—physical 
antecedents—call forth mental states and muscular movements 
which are mutually responsive. They indicate that various 
functions are automatic (not dependent upon the will), and as 
we have seen, experiments indicate that the electric current, 
when applied to the cerebrum, excites involuntary, reflex action. 
We cannot say how far these experimental results justify the 
phrenological classification of the faculties of mind, by estab- 
lishing a causative relation between the physical and psychical 
states. The short and unsatisfactory account given, furnishes 
one fact which seems to support the claim of such a relation, 
viz: the apparent similarity between the motor center of the lips 
and tongue in lower animals, and that portion of the human 
cerebrum where disease is so often found to be associated with 
Aphasia (loss of voice). While this is by no means conclusive 
in establishing an hypothesis, it is a significant correspondence 
favoring it. These experiments are opening to scientists a 
new field for research, and we welcome their labors, hoping that 
they may yield an abundant harvest of discovery. 
176. It is wonderful that nervous matter, can be so arranged, 
as not only to connect the functional processes of the body, but 
at the same time to be the agent of sensation, thought and 
emotion. It is amazing, that a ray of light containing vital 
stimuli, after traversing a distance of 91,000,000 miles, can, by 
falling upon the retina, not only produce a contraction of the 
pupil, but excite thoughts which analyze that ray, instantly 
spanning the infinitude of trackless space ! The same penetra- 
tive faculties, with equal facility, can quickly and surely discern, 
the morbid symptoms of body and mind, become familiar with 
the indications of disease and classify them scientifically with the 
phenomena of nature. The symptoms of disease follow certain 
conditions as regularly as do the signs of development, and mind 
itself is no exception to this uniformity of nature. Thoughts 140 
COMMON SENSE MEDICAL ADVISEE. 
result from conditions and manifest them as evidently as the falling 
rain illustrates the effect of gravity. The knowing, and highest 
emotive faculties of man, depend upon this simple,'but marvel- 
ously endowed, nervous substance, which blends the higher 
spiritual, with the lower physical processes. The functions of 
the body are performed by separate organs, distinguished by 
peculiar characteristics. To elucidate the distinctions between 
dissimilar mental faculties, we have assigned their functions, with 
characteristic names, to different regions of the head. As they 
unquestionably influence the bodily organs, we are sustained by 
physical analogy, in our classification. Our knowledge of the 
structure and functions of the nervous system is, as yet, element- 
ary, and we are patiently waiting for scientists to develop its 
facts and verify them by experimental investigations and such 
researches, as time alone can bring to perfection. While real 
progress moves with slow and measured foot-steps, the inspira- 
tions of consciousness and the inferences of logic prepare the 
popular mind for cerebral analysis. No true system can contra- 
dict the facts of our inner experience; it can only furnish a 
more complete explanation of their relation to the bodily or- 
gans. It should be expected that such careful, or pains-taking 
experiments, as are necessary to establish a science, will be 
preceded by intuitive judgment and accredited observations, 
which may be, for a time, the substitutes of those more abstruse 
in detail. 
177. We have, in accordance with popular usage, treated the 
organs of thought as having anatomical relations. The views 
which we have presented in this chapter may seem speculative, 
but the facts suggesting the theory, demand attention, and we 
have attempted to gather a few of the scattered fragments and 
arrange them in some order, rather than leave them to uncer- 
tainty and greater mystery. It is by method and classification 
that we are enabled to apply our knowledge to practical pur- 
poses. Possibly, to some, (especially the non-professional), an 
allusion to the fact that cerebral physiology contributes to suc- 
cessful results in the practice of medicine, may seem to be an 
exaggerated estimation. None, however, who are conversant 
with the facts connected with the authors experience, will so 
regard this practical reference, for the statement might be greatly CEREBRAL PHYSIOLOGY. 
141 
amplified, without exceeding the bounds of truth. Physicians 
generally undervalue the nervous functions, and overlook the 
importance of the brain as an indicator of the conditions of the 
physical system, because they are not sufficiently familiar with 
its influence over the bodily processes. Pathological conditions 
are faithfully represented by the thoughts, and words, when 
used to describe symptoms, become the symbols of feelings which 
arise from disease. How few physicians there are, who can in- 
terpret the thoughts and glean from the expressions and sentences 
of a letter, a correct idea of the morbid conditions which the 
writer wishes to portray ! Each malady, as well as every tem- 
perament, has its characteristics, and both require careful and 
critical analysis before subjecting the patient to the influence 
of remedial agents. 
178. Iii a treatise by Dr. Joseph R. Buchanan, entitled “Out- 
lines of Lectures on the Neurological System of Anthropology” 
(a work which we hope to see revised and enlarged), are presented 
original ideas pre-eminently useful to the physician. His 
researches, and those of later writers, together with our own 
investigations, have greatly extended the author’s philosophic 
and professional knowledge. It is by such studies and investiga- 
tions that we have been prepared to interpret, with greater 
facility, the indications of disease, diagnosing accurately from 
symptoms, which have acquired a deeper significance in the light 
of cerebral physiology. We are enabled to adapt remedies to 
constitutions and their varying conditions, with a fidelity and 
scientific precision which has rendered our remedial success 
widely known and generally acknowledged. We annually treat 
thousands of invalids, whom we have never beheld, relieving them 
of their ailments. This has been accomplished chiefly through 
correspondence. If, for any reason, patients have failed to 
delineate their symptoms correctly, or given an obscure account 
of their ailments, photographs have been forwarded for our 
inspection, which have materially assisted in disclosing the nature 
of the disease. The cerebral conformation indicates the predis- 
position of the patient and enables us to estimate the strength of 
his recuperative energies. Thus we have a valuable guide in 
the selection of remedies particularly suited to different constitu- 
tions. Our treatment has been chiefly of chronic and nervous 142 
COMMON SENSE MEDICAL ADVISER. 
diseases. The success attending our efforts, has been widely 
appreciated, not only in this, but in other countries where civili- 
zation, and its concomitants of refinement and luxurious habits, 
culture and effeminating customs, prevail. This fact is mentioned, 
not only as an illustration of the personal benefits actually 
derived from a thorough knowledge of the nervous system, but 
to show how generally and extensively these advantages have 
been shared by others. 
179. A careful study of cerebral physiology leads us deeper 
into the mysteries of the human constitution, to the philo- 
sophical contemplation of the relations of mind to body and is 
a direct avenue to facts and conditions essential to individual 
improvement. Self-culture implies not only a knowledge of the 
powers of the mind, but also how to direct and use them for its 
own improvement, and he who has the key to self-knowledge, 
can unlock the mysteries of human nature and be eminently 
serviceable to the world. For centuries the mind has been 
spreading out its treasury of revelations, to be turned to practical 
account, in ascertaining the constitution, and determining better 
methods of treating disease. Since comparative anatomists and 
physiologists have revealed the structure of animals and the 
function of their organs, from the lowest radiate to the highest 
vertebrate, the physician may avail himself of this knowledge, 
and thus gain a deeper insight into the workings of man—the 
epitome of all nature. An intimate acquaintance with the 
physical, is a necessary preparation for the study of the psychical 
life, for it leads to the understanding of their mutual relations 
and reactions, both in health and disease. 
180. Consciousness, or the knowledge of sensations and mental 
operations, has been variously defined. It is employed as a col- 
lective term to express all the psychical states, and is the power 
by which the soul knows its own existence. It is the immediate 
knowledge of any object whatever, and seems to comprise, in its 
broadest signification, both matter and mind, for all objects are 
inseparable from the cognizance of them. Hence the significance 
of the terms, Subject-consciousness and Object-consciousness. 
People are better satisfied with their knowledge of matter than 
their conceptions of the nature of mind. CEREBRAL PHYSIOLOGY. 
143 
THE NATURE OF MIND. 
Since this subject is beifig discussed by our most distinguished 
scientists, we will conclude this chapter by introducing an extract 
from a lecture delivered by Prof. Burt G. Wilder, at the American 
Institute: 
181. “There now remains to be disposed of, in some way, the 
question as to the nature and reality of mind, which was rather 
evaded at the commencement of the lecture. The reason was, 
that I am forced to differ widely from the two great physiologists 
whom I have so often quoted this evening. Most people, follow- 
ing in part early instruction, in part revelation, in part spiritual 
manifestations, and in part trusting to their own consciousness, 
hold, that the human mind is a spiritual substance which is asso- 
ciated with the body during the life of the latter in this world, 
and which remains in existence after the death of the body, and 
forms the spiritual clothing or embodiment of the immortal soul; 
and that the individual, therefore, lives after death as a spirit in 
the human form; that of this spiritual man, the soul is the essen- 
tial being, of which may be predicted a good or evil nature, while 
the mind, which clothes it as a body, consists of the spiritual 
substances, affections and thoughts, which were cherished and 
formed during the natural life. 
Together with the above convictions respecting themselves, 
most people, when thinking independently of theological subli- 
mations, feel willing to admit that animals have, in common with 
men, fewer or more natural affections and thoughts which make 
up their minds, but that the inner and immortal soul, which 
would retain them as part of an individual after death of the 
body, is not possessed by the beasts that perish. In short, the 
vast majority of mankind, when thinking quietly, and especially 
in seasons of bereavement, feel well assured of the real and sub- 
stantial existence of the human mind, independently of its 
temporary association with the perishable body. 
But in antagonism to this simple and comforting faith, stand 
theological incomprehensibilities on the one hand, and scientific 
skepticism on the other. The former would have us believe that 
the soul is a mere vapor, a cloud of something ethereal, of which 
can be expected, nothing more useful than ‘ loafing around the 144 
COMMON SENSE MEDICAL ADVISEE. 
Throne;’ while the latter asks us to recognize the existence of 
nothing which the eyes cannot see and fingers touch; to cease 
imagining that there is a soul, and to.regard the mind as merely 
the product of the brain; secreted thereby as the liver secretes 
bile. Let us hear what the two leading nervous physiologists, 
of this country, have to say upon this point: 
‘ The brain is not, strictly speaking, the organ of the mind, for 
this statement would imply that the mind exists as a force, inde- 
pendent of the brain; but the mind is produced by the brain 
substance: and intellectual force, if we may term the intellect a 
force, can be produced only by the transmutation of a certain 
amount of matter; there can be no intelligence without brain 
substance. ’—Flint. 
‘ The mind may be I'egarded as a force, the result of nervous 
action, and characterized by the ability to perceive sensations, to 
be conscious, to understand, to experience emotions, and to will 
in accordance therewith. Of these qualities, consciousness resides 
exclusively in the brain, but the others, as is clearly shown by 
observation and experiment, cannot be restricted to that organ, 
but are developed with more or less intensity, in other parts of 
the nervous system.’—Hammond. 
Thus do the two extremes of theology and science meet upon 
a common ground of dreamy emptiness, and we who confess our 
comparative ignorance are comforted by the thought that some 
other things have been ‘ hid from the wise and prudent and re- 
vealed unto babes.’ Yet, while feeling thus, it must be admitted 
that the existence of spirit and of a Creator do not yet seem ca- 
pable of logical demonstration. The denial of their existence is not 
incompatible with a profound acquaintance with material forms 
and their operations; and on the other hand, the belief in their 
existence and substantial nature, and in their powers as first 
causes, have never interfered with the recognition of the so-called 
material forces, and of the organisms through which they are 
manifested. At present, at least, these are purely matters of 
faith; but although the Spiritualist (using the term in its broadest 
sense as indicating a belief in spirits), may feel that his faith 
discloses a beauty and perfection in the union, otherwise imper- 
ceptible by him, there is no reason why this difference in faith 
should make him despise or quarrel with his materialist co-worker, OEEEBBAL PHYSIOLOGY. 
145 
for the latter may do as good service to science, may be as true 
a man, and live as holy a life, although from other motives. 
182. The differences between religious sects are mainly of 
faith, not of works, and the wise of all denominations are grad- 
ually coming to the conviction that they will all do God more 
service by toleration and co-operation than by animosity and 
disunion. And so I hold that, until the spiritualist feels himself 
able to demonstrate to the unbeliever the existence of spirit and 
of God, as convincingly as a mathematical proposition, there 
should be no hard words or feelings upon these points. For the 
present they are immaterial in every sense of the'word; and so 
long as a materialist is sincere and earnest; so long as he bows 
to the facts and the laws of Nature, and deals with his fellow- 
men as he would be done by, so long will I work with him, side 
by side, knowing, even though I cannot tell him so, that whether 
or not, he joins me in this world, we shall meet in the other 
world to come, where his eyes will be opened, and where his 
lips will at least acquit me of bigotry and intolerance.” CHAPTER XV. 
HUMAN TEMPERAMENTS. 
183. Organization implies vital energy, as it can have no 
function without this living power. Antecedent to the initiation 
of life, is the sperm cell—the little casket which holds the latent 
vitality. The early history of this little world — the fertilizing 
cell — composed of infinitesimal molecules which contain the 
embryo powers of life, is only partially written. It is a fact 
authenticated by Faraday, that one drop of water contains, and 
may be made to evolve, as much electricity as under a different 
mode of display would suffice to produce a lightning-flash. 
Chemical force is higher than physical, and vital force is of a 
still higher order. Within the microscopic compass of the sperm 
cell are a great number of forces acting simultaneously, which 
require the answering conditions of a germ cell, and are so 
blended as to occupy a minimum of space. The union of these 
subtle elements through the agency of their physical, chemical 
and vital forces, constitutes the initiation of life. Functions 
disclose the fact that this life is a transitive process, its stand- 
still, death. Elementary matter is transformed into chemical, and 
organic compounds, by natural forces, upon the cessation of 
which, it is liberated by nature’s great destroyer, and reappears 
in the world of elements. Thus, man is formed out of the very 
dust by means of energies which reconstruct the crude, inert 
matter,— and to dust he returns when those energies cease. 
184. As we enter upon the consideration of the temperaments, 
we should bear in mind one peculiarity of life, viz: that it com- 
bines, in a small space, many complex powers—definite life-forces 
— representing the conditions of parentage. In the physiology HUMAN TEMPERAMENTS. 
147 
of reproduction, there is a wonderful compounding and re-com- 
pounding of organic elements, which are again manifested by 
their transforming energies. Structures differ as widely, a3 
their functions. So likewise do animals vary in their nature 
and organization, and individuals of the same species are, to a 
certain degree, unlike. Yet the characteristics, which have dis- 
tinguished the races of mankind, are fundamental and faithfully 
maintained. Time does not obliterate them. Within race-limits 
are found enduring peculiarities, and although each individual 
is weaving out some definite pattern of organization, it follows 
the type of the race, as well as the more immediate antecedent 
conditions. 
185. What then is a Temperament but a “mixing together” 
of these determining forces, a certain blending manifested in the 
constitution by signs, or traits which we distinguish as character. 
The different races of mankind must have their several standards 
of temperament, for the peculiarities of one are not fully descrip- 
tive of, and applicable to the other. Prof. Robley Dunglison 
defines temperament as follows: 
“ Those individual differences which consist in such dispro- 
portions of parts, as regards volume and activity, as to sensibly 
modify the whole organism, but without interfering with healths 
Dr. J. R. Buchanan’s definition is more concise: “ A tempera- 
ment may be defined to be a peculiar and habitual condition of 
the human constitution, arising from the combined action of its 
organic forces.’1'' 
For its simplicity and scope, we prefer the following definition 
suggested by our friend, Orin Davis, M. D.: A Temperament is 
A COMBINATION OF ORGANIC ELEMENTS SO ARRANGED AS TO 
CHARACTERIZE THE CONSTITUTION. 
186. This leads us to consider some of the elements, condi- 
tions and forces which give character to the organization. Ex- 
ternal circumstances supply necessary conditions to inward 
activity, for without air, food or sunlight all living animals 
would perish. Every-where, life is dependent upon conditions 
and circumstances — it is not self-generating. But the condi- 
tions of reproduction are very complex. External forces are 
transformed, and in turn, become vital, i. e.y— formative powers. 
Development is a transmutation of physical and chemical forces 148 
COMMON SENSE MEDICAL ADVISER. 
into vital energy. Although unable to compute the ultimate 
factors of life, yet we may illustrate their reproductive possibili- 
ties and results by comparing them with those of a lower order. 
187. Animal structures are mainly composed of four elements, 
viz: oxygen, hydrogen, nitrogen and carbon. Other constituents 
enter into their composition, but are, comparatively, of inci- 
dental importance. From these four ingredients is fabricated an 
organism which manifests properties and marvelous functions. 
If the proportion of these chemical elements be varied, the or- 
ganic compound will be changed; again, the proportions remaining 
the same, if the grouping of the elements be altered, different com- 
pounds wfill be produced, showing that the properties of organized 
substances depend upon the molecular constitution of matter. 
188. Rising in the scale of organization, we observe that 
every variation of the physical and chemical processes implies 
a corresponding modification of the vital. This is verified by 
the peculiarities of the several races of mankind. Individual 
differences are likewise modifications of these processes. Dynam- 
ical or vital differentiation depends upon these modifications for 
the display of vital energy, and is always associated with molecular 
changes. But it should be borne in mind that an effect may 
not resemble its cause in properties, and the qualities of a 
chemical compound may be quite different from those of its 
constituents. Organic matter, although more complex, may 
exhibit properties, both like and unlike its constituent elements. 
Within certain boundaries, the elements seek to satisfy their 
affinities. We discover that there are limits between the genera 
of animals, as well as the races of mankind. Not less really, 
though perhaps not as absolutely, are there individual precincts 
within the sphere of the human temperaments, which cannot be 
passed. 
189. If we cannot satisfactorily explain, we at least, begin to 
discover a reason for temperamental limitation. It is not 
designed to circumscribe healthful reproduction, but to serve as 
an effectual hindrance to abnormal deviations. We may state 
our belief in more positive terms, viz: that the temperamental 
variations are essential to genesis and fertility, and indispensable 
to health and normal development. 
Every individual is susceptible to impressions which dispose to HUMAN TEMPERAMENTS. 
149 
action. Impressions which excite or increase this disposition, are 
called Stimuli. Vital change implies, (1). Stimuli and (2). Suscep- 
tibilities. The stimulus may not be furnished because the condi- 
tions on which it depends are wanting; again, susceptibility may 
exist at one time and not at another. Stimuli and susceptibility 
may be present in different degrees, but for the purpose of health- 
ful reproduction they must not be. impaired. Illustration:— 
No single proximate principle is sufficient for the nutrition of 
the body, but, the food must contain substances belonging to each 
of the different groups. If an animal be fed exclusively upon 
albumen, although this substance constitutes the largest part of 
the bodily mass, yet exhaustion will rapidly follow, since the 
food does not contain all the essential, nutritive stimuli. Again, 
when the solids of the body have been wasted, they lose their 
susceptibility to stimuli, and the food does no good. Thus 
patients become emaciated during acute attacks of disease, upon 
the cessation of which they are too feeble to recover, simply 
because they have lost nutritive susceptibility. 
190. We may apply this illustration to temperaments. The 
multifarious powers of the sperm cell require conditions for 
their manifestation. These vital potencies are an epitome of 
the parent constitution, and the Stimuli to evolution. The 
germ cell responds to that of the sperm, by furnishing the con- 
ditions,-or susceptibilities, and these constitute its germinal 
capacities. When a stimulus is communicated to these conditions, 
the response is the organization of tissues. Health and fertility 
are dependent upon this dualism of conditions — stimuli and 
susceptibility — upon the action and reaction of which,depends 
not only organization, but longevity; and the absence, or dor- 
mancy of these conditions,results in death. 
191. In inanimate forms, (as crystals), forces come to rest, 
but the very idea of life implies action, not cessation—vital 
change, not rest. Hence diversity of constitutions, and different 
temperaments—unlikeness in the proportion, strength and influ- 
ence of organs and their functions—are essential in order that 
marriage may result in the reproduction of vigorous forces, for 
life is inaugurated between stimuli and responding susceptibilities. 
Their differentiation is determined by the natural dissimilari- 
ties of constitution, represented by the temperaments. 150 
COMMON SENSE MEDICAL ADVISEE. 
192. A loss of stimuli and susceptibility, implies correspond- 
ing loss of fertility; or, if reproduction be possible, the health of 
the progeny is impaired and life made brief. The fact that 
these powers are necessary to institute molecular changes, will 
not be questioned. Our present inquiry is concerning the condi- 
tions in which they originate. Certain organic conditions are 
favorable to the production of these powers, i. e., we recognize 
causative relations depending upon physical changes, which 
may be increased or diminished. Certain operations induce an 
absolute waste of the vital powers, without returning any 
compensation, while others are followed by incidental benefits. 
Since these conditions are represented by the temperaments, we 
classify them as 
In the preceding chapter, we attempted to illustrate the 
unique blending of mind and body by means of the nervous 
system, and we now propose to exemplify the physical condi- 
tions of the organism by certain correspondencies, observed in 
the development and conditions of that system. If nature 
answers to mind in physical correspondencies, she will observe 
the same regularity in physical development. The simplest 
classification of the temperaments is represented in Fig. 77. 
Not only is mental activity dependent upon a chemical, reaction 
between the blood and the brain, but the 
development of the cerebrum depends 
upon its supply of blood The growth of 
the intellect observes the same conditions 
that aided in the development of Yulcan’s 
right arm, viz: waste and supply—disin- 
tegration and reformation of the tissues. 
He was the god of fire, who presided over 
the working of metals, and our modern 
iron forge, shows many an artisan, whose 
great right arm proclaims him to be a son 
of power as well as of fire. Thus the fer- 
vid intellect while forging out its thoughts, increases in size and 
strength. The difference between the development of the two 
is this; that the exercise of the blacksmiths right arm quickens 
VITAL AND NON-VITAL. 
Fig. 77. HUMAN TEMPERAMENTS. 
151 
the activities of all the bodily functions, whereas the employment 
of the intellect does not offer any healthful equivalent. Physi- 
cal exercise is a hygienic demand, but intellectual employment 
excites no salutary influences, while it is constantly expending 
the energies of the blood. The emotionsrlikewise, make exhaust- 
ing draughts upon nutrition to supply the waste of brain- 
substance, just as essentially as physical labor causes muscular 
change and demands reparation. One expends cerebral, the 
other, muscular substance. The one is healthful in its general 
tendencies, the other, comparatively, wasteful and destructive. 
Disintegrating, 
Expending, 
Deriving. 
The intellectual faculties are, 
Engrossing, 
Exhausting, 
Devitalizing. 
The emotive faculties are, 
These nervous forces are transformed into spiritual products. 
193. The base of the anterior lobes of the brain belong to 
the Atonic Region — the source of those languid, deranging 
influences, which coincide with morbidity and disease. A dis- 
turbance of the corporeal organs, which especially influence this 
portion of the brain, naturally tends to the development of insan- 
ity or imbecility. Morel has traced, through four generations, 
the family history of a youth who was admitted to the asylum 
at Rouen while in a state of stupidity and semi-idiocy; the fol- 
lowing summary of his investigations illustrates the natural 
course of degeneracy as it extends through successive genera- 
tions. First generation: Immorality, depravity, alcoholic excess 
and moral degradation, in the great-grandfather, who was killed 
in a tavern brawl. Second generation: Hereditary drunkenness, 
maniacal attacks, ending in general paralysis, in the grandfather. 
Third generation: Sobriety, but hypochondriacal tendencies, de- 
lusions of persecutions, and homicidal tendencies in the father. 
Fourth generation: Defective intelligence in the son. First 
attack of mania at sixteen; stupidity, and transition to complete 
idiocy. Furthermore, a probable extinction of the family, for 
his generative functions were as little developed as those of a 
child of twelve years of age. He had two sisters who were both 
defective physically and morally, and were classed as imbeciles. 152 
COMMON SENSE MEDICAL ADVISER. 
To complete the proof of heredity in this case, Morel adds that the 
mother had a child while the father was confined in the asylum, 
and that this child exhibited no signs of degeneracy. Statistics 
show that multitudes of human beings are born weighted with a 
Mg. 78. 
destiny against which they have neither the will nor the power to 
contend. They groan under the worst of all tyrannies — the tyr- 
anny of a had organization, which is theirs by inheritance. We 
may represent the tendencies of the anterior portion of the brain 
by Fig. 78. The functional exercise of the anterior and superior 
portions of the cerebrum is disintegrating and devitalizing, while HUMAN TEMPERAMENTS. 
153 
the anterior and inferior portions coincide with mental and 
physical derangement, unless counteracted by opposing forces. 
It is therefore evident that in any organization, upon which is 
entailed a perverted or excessive action of this portion of the 
cerebrum, the tendencies are non-vital, i. e., unfavorable to 
fertility and physical health. 
194. If the antagonizing regions are well developed, the ten- 
dencies are favorable to life. 
Sanity, 
Temperance, 
Hardihood. 
The volitive organs are promotive of, 
The animal organs tend to, 
Nutrition, 
Restoration, 
Conservation. 
The basilar faculties instigate, 
Secretion, 
Circulation, 
Vitality. 
Energy, 
Health, 
Reproduction. 
The combined action of these facul- 
ties express, 
If this portion of the brain indicates a full development, we 
say of such a temperament, it is vital, because the functions of 
its nerve-centers are favorable to evolution. As degenerations 
observe conditions, so endurance and development conform to 
certain laws, and it behooves all truthful enquirers, who believe 
not only in the progress of human intelligence, but in physical 
improvement from generation to generation, to ascertain and 
comply with these essential conditions. When the anterior and 
middle lobes of the brain are fully developed at their inferior sur- 
faces, it is regarded as an insane temperament, i. e., containing 
the germs of mental and bodily derangement. Both Morel and 
Dr. J. R. Buchanan have pointed out as an indication of insane 
neurosis, a conformation of the head which indicates lack of har- 
mony, and ofttimes exhibits a malformation of the external ear. 
195. How shall we distinguish the combination of organic 
elements, if not by the manner in which they characterize the 
constitution? Every human being is distinguished by natural 
peculiarities, both mental and physical. These are indicated not 
only by the color of the eyes, hair and skin, and the mental 
expressions, but in the conformation and capabilities of the 154 
COMMON SENSE MEDICAL ADVISEE. 
corporeal system. The color, form, size and texture of a leaf 
indicate to the expei’t pomologist the nature of the fruit which 
the tree will bear, but how much more important to understand 
the hai’monies of human development. If Prof. Agassiz could 
determine the form and size of a fish by seeing its scales, and 
Prof. Owen outline the skeleton of an unknown animal by view- 
ing a portion of its fossil, why should not the physician under- 
stand the language of temperaments, as it opens to him the 
revelations of human development ? The sculptor blends char- 
acter with foi-m, the artist endows the face with natural 
expi-ession, the surgeon accurately traces the nerves and arteries, 
the physiognomist reads character, which the novelist delineates 
and the actor personates, because there are behind all these, 
facts, the materials whei’ewith to construct a science. In organ- 
ization there are permanent forces which operate uniformly, thus 
revealing the order of nature. 
THE TEMPERAMENTS CLASSIFIED. 
196. We propose to speak of four constitutional variations 
entitled to separate consideration, viz: The lymphatic, the 
sanguine, the volitive and the encephalic. The brain con- 
trols all the voluntary, and modifies the involuntary functions of 
the body. It exerts special sway, i. e., 
portions of the brain influence correspond- 
ing portions of the body. A particular 
cerebral development modifies the func- 
tions of all the bodily organs, and thus 
tempers the constitution. We therefore 
shall base our temperaments upon the 
mental and physiological characteristics, 
which ax-e portrayed by cerebral develop- 
ment. Such an arrangement is illustrated 
by Fig. 79. 
Fig. 79. 
THE LYMPHATIC TEMPERAMENT. 
197. The lymphatic temperament predominates when the 
anterior base of the brain and the middle lobe are developed so 
as to exert a preponderating influence over the bodily functions, 
The character of this influence we have described in cerebral phy- 
siology, (see 108). It is difficult to state precisely the normal LYMPHATIC TEMPERAMENT. 
155 
influences and neural forces which arise from these faculties, but 
it is evident that they are specially related to nutritive attraction, 
in opposition to volitive repulsion. It is only their excessive 
influence that produces worthless, miserable, morbid characters. 
A constitution marked by this development is indolent, relaxa- 
tive and an easy prey to epidemics. This temperament is also 
characterized by a low grade of vitality or resistance. When 
life is sustained by the volitive powers, it is distinguished by a 
softness of the bodily structures, and the prevalence of lymph. 
The fact that all the organic functions are performed indolently, 
indicates lack of vital power. An excellent illustration of this 
temperament is found in Fig. 80 which represents a Chinese 
gentleman of distinction. In the lower order of animals, as in 
Fig. 80. 
sponges, absorption is performed by contiguous cells, which are 
quite as effortless as in plants. Because of their organic indo- 
lence, sponges are often classed as vegetables. A body having 
an atonic or a lymphatic temperament is abundantly supplied 156 
COMMON SENSE MEDICAL ADVISER. 
with absorbant organs, which are very sluggish in their operations. 
In lower animals, life is diffused throughout their structures. So 
in the lymphatic temperament, there seems to be less construc- 
tive energy, slower elaboration, and greater frugality. Lymph 
is a colorless or yellow fluid containing a large proportion of 
water. It is not so highly organized as blood, but resembles 
it, when that fluid is deprived of its red corpuscles. In the 
sanguine temperament, the blood-vessels are the most diligent, 
the lacteals next, and the lymphatics the least so, but in the 
lymphatic temperament, the order of this activity is reversed. 
198. Dr. W. Byrd Powell observes that the lymphatic man 
has a large head, while the fat man has a small one, and also, 
that fat and lymph are convertible, one following the other, i. e., 
“ a repletion consisting of fat may be removed, and one of lymph 
may replace it, and vice versa.” He could not account for these 
alternations. The bear goes into his winter quarters, sleek and 
fat, and comes forth in the spring just as plump with lymph, but 
losing this fat appearance soon after obtaining food. This simply 
indicates, that during lymphatic activity, the digestive organs 
are comparatively quiescent. But when these are functionally 
employed again, lymphatic economy is not required (see 60, 
61). It is the duty of the lymphatics to slowly convert the fat 
by such transformation, that when it reaches the general circu- 
lation, it may there conjugate with other organic compounds, 
the process being aided by atmospheric nitrogen, introduced 
during the act of respiration. In this way it may become 
changed into those, chemically indefinite, artificial products, 
called proteinaceous compounds. This view is supported by the 
disappearance of fat as an organized product in the lymph of the 
lymphatic vessels, indicating that such transformation has oc- 
curred. In this way, by coupling with other organic compounds, 
it shows how the lymph may serve as a weak basis for blood; 
that atmospheric nitrogen is so employed in forming these arti- 
ficial compounds, is indicated by the fact that there is sometimes 
less detected in arterial, than in venous blood. 
199. This temperament is indicated by lymphatic repletion, 
soft flesh, pale complexion, watery blood, slow and soft pulse, 
oval head, broad skull, showing breadth at its base. Fig. 81 
illustrates this temperament combined with sanguine elements. LYMPHATIC TEMPERAMENT. 
157 
In all good illustrations of this temperament, there is a breadth 
of the anterior base of the skull extending forward to the cheek 
bones. There is likewise a corresponding fulness of the face, 
under the chin, and in the neck, denoting a large development of 
Fig. 81. 
Judge Green, of the United States Court. 
the anterior base of the cerebrum. The cerebral conformation 
of the Hon. Judge Green, indicates mental activity, and we have 
no reason to suppose that lymph was pai’ticularly abundant in 
his brain. 
200. While this description of the lymphatic temperament is 
correct, when illustrated by the civilized races of men, who are 
accustomed to luxury, ease and an abundance of food, it does 
not apply with equal accuracy to the cerebral organization of the 
American Indian. His skull, though broad at its anterior base, 
and high and wide at the cheek bones, differs from the European 
in being broader and longer behind the ears. Fig. 82 is an 
excellent representation of a noted North American Indian. 
This portrait is taken from Samuel R. Well’s admirable work 
entitled “New Physiognomy,” which contains more than a 158 
COMMON SENSE MEDICAL ADVISER. 
thousand faithful portraits of distinguished men and women. 
While a great breadth of the base 
of the brain indicates morbid sus- 
ceptibilities, yet these, in the Indian, 
are opposed by a superior height of 
the posterior part of the skull. 
Consequently, he is restless, impul- 
sive, excitable, passionate, a vagrant 
upon the earth. The basilar facul- 
ties however are large, and he is 
noted for instinctive intelligence. 
His habits alternate from laziness to 
heroic effort, from idleness and 
quiet to the fierce excitement of the 
chase, from vagabondism to war, 
sometimes indolent and at other 
times turbulent, but under all circumstances, irregular and un- 
reliable. In this case, lacteal activity is greater than lymphatic, 
as his nomadic life indicates. Nevertheless, he manifests a mor- 
bid sensibility to epidemic diseases, especially those which 
engender nutritive disorders and corrupt the blood. Figs. 83 
and 84 represent the brain of an American Indian, and that of a 
European, and show the remarkable difference between their 
anatomical configuration. Evidently it is a race-distinction. 
Observe the greater breadth of the brain of the Indian, which 
according to cerebral physiology indicates full alimentiveness, 
indolence, morbid sensibility, irritability and profligacy, but also 
note that it differs materially in the proportion of all its parts, 
from the European brain. Judging of the character of the 
Indian from the foregoing representation, we should say, that he 
was cunning, excitable, treacherous, fitful, taciturn or violently 
demonstrative. His constitution is very susceptible to diseases of 
the bowels and blood. His appetite is ungovernable, and the love 
of stimulus, strong. Syphilitic poison, small-pox, and strong drink 
will annihilate all these tribes sooner than gunpowder. Their 
physical traits of constitution are no less contradictory than their 
extremes of habit and character, for while there is evidence of 
lymphatic elements, yet it is contradicted by the color of the 
hair, eyes and skin. This peculiar organization cannot blend in 
Fig. 82. LYMPHATIC TEMPERAMENT. 
159 
healthful harmony with that of the European, and furthermore, it 
Fig. 83. 
Fig. 8J+. 
American Indian. 
European. 
(From Morton’s Crania Americana.) 
In the American Indian, the anterior lobe, lying between A A and B B, is small, 
and in the European it is large, in proportion to the middle, lying between B B and 
VC. In the American Indian, the posterior lobe, lying between Cand D, is much 
smaller than in the European. In the American, the cerebral convolutions on the 
anterior lobe and upper surface of the brain, are smaller than the European. If the 
anterior lobe manifest the intellectual faculties — the middle lobe, the propensities 
common to man with the lower animals—and the posterior lobe, the conservative 
energies, the result seems to be, that the intellect of the native American will be com- 
paratively feeble — the European, strong; the animal propensities of the Indian will 
be great —in the European, more moderate; while reproduction, vital energy and 
conservation of the species of the Indian is not as great as with the European. The 
relative proportions of the different parts of the brain, differ very materially. 
shows that race-temperaments require separate and careful 
analytic considerations. 
201. By physical culture and regulation of the habits, the 
excessive tendencies of this temperament may be restrained. 
Solid food should be substituted for a watery diet. If it be 
limited in quantity, this change will not only diminish the size, 
but increase the strength of the body. The body should be dis- 
ciplined by daily percussion (gently and rapidly repeating the 
blows upon its surface), until the quasi-constructed cells which 
are too feeble to resist this treatment, are broken and replaced by 
those more hardy and enduring. Add to this treatment brisk, 
dry rubbing, calisthenic exercises, and daily walks which should 160 
COMMON SENSE MEDICAL ADVISER. 
be gradually extended. Continue this treatment for three 
months, and its improving effects upon the tempei'ament will 
surprise the most skeptical; if continued for a year, a radical 
alteration will be effected, and the hardihood, health, and vigor 
of the constitution greatly increased. 
202. This temperament may be improved physiologically, 
by being blended with the sanguine and volitive, and the off- 
spring will be stronger, the structures firmer, the organization 
more dense. Nutrition, assimilation and all the constructive 
functions will be more energetic in weaving together the cellular 
fabric of the body. The sanguine temperament will add a stim- 
ulus to the organic activities, while the volitive will communicate 
manly, brave and enduring qualities. When this temperament 
is united with the encephalic, if it does not result in barreness, it 
adds expending and exhaustive tendencies to the enfeebled ones 
already existing, and consequently the offspring will lack both 
physical power and intellectual activity. 
203. The peculiarities of this temperament are observable in 
the diseases which characterize it. It is specially liable to de- 
rangements of digestion, nutrition and blood-making. The blood 
is easily poisoned, by morbid products formed within the body, 
as well as by those derived from the body of another. This is 
seen in purulent infection of the blood, sometimes called pus- 
blood, because inflammation in some part of the system has termi- 
nated in pus (matter). When this is absorbed, it acts upon the 
blood as a poison. This is most likely to occur when the vital 
powers are low and the energies weak, for then the fibrine de- 
creases, the red globules diminish in number, the circulation 
becomes languid, the pulse grows fluttering and weak, and this 
continues until death ensues. This poisoned condition of the 
blood is technically termed pyaemia. An individual of this tem- 
perament is more easily destroyed than any other by the poison 
of syphilis, small-jjox and other contagious diseases. If the 
blood has received any hereditary taint, the lymphatic glands not 
only reproduce it but oftentimes increase the virulency of the 
original disease. This temperament indicates a necessity for 
the employment of stimulating, alterative and anti-septic medi- 
cines. The torpid functions need arousing, the blood wants 
depuration, i. e., the elimination of corrupting matter, and the SANGUINE TEMPERAMENT. 
161 
system requires vegetable alteratives to produce these salutary 
changes. The secretions need the correcting influence of cleans- 
ing remedies for the purification of the blood. 
Persons of this temperament are more liable to absorption of 
pus and other morbid products within the body, which are in a 
state of decomposition, producing a putrid infection of the blood, 
technically termed, septicaemia. The fatal results which so sud- 
denly follow child-bed fever are thus produced. This kind of 
poisoning sometimes takes place by the absorption of decomposed 
exudation in diptheria and, though rarely, from matter collected 
in the lungs. Whenever the absorption of poison does take 
place, fatal consequences speedily follow. 
204. This passive temperament is more liable to sink under 
acute attacks of disease, especially alimentary disorders, such as 
diarrhoea, dysentery and cholera. It quickly succumbs to their 
prostrating effects, as depression, congestion and fatal collapse 
rapidly succeed each other. Venesection and harsh purgatives 
are contra-indicated, and the physician who persists in their 
employment, kills his patient. How grateful are warmth, and 
stimulating medicines ! The most powerful, diffusible and ner- 
vous stimulants are required in cholera, when the system is 
devastated by the disease, as the plain is laid waste by the fierce 
tornado. Without a critical knowledge of the morbid tendencies 
of such a temperament, a physician, although loaded down with 
diplomas and degrees, is illy prepared to treat his patients with 
any probable success. 
THE SANGUINE TEMPERAMENT. 
205. Lymph is the characteristic of the lymphatic tempera- 
ment, and its specific gravity, temperature and standard of 
vitality are all lower than that of red blood. In the sanguine 
temperament all the vital functions are more active, the blood 
itself has a deeper hue, its corpuscles carry more oxygen, the 
complexion is quite florid, and the arterial currents impart to 
every faculty a more hopeful vigor. The blood-vessels are the 
most active absorbents, eagerly appropriating nutritive materials 
for the general circulation, while respiration adds to it oxygen, 
that agent which makes vital manifestation possible. This tem- 
perament exhibits greater sensibility, the conceptions are quicker, 162 
COMMON SENSE MEDICAL ADVISEE. 
the imagination more vivid, the appetite stronger, the passions 
more violent, and there is to be found every display of animal 
life and enjoyment. 
206. A full development of the basilar faculties, indicated by 
an unusual breadth and depth of the occipital base of the brain, 
accompanies this temperament. Its cerebral area includes the 
posterior and inferior portions of the cerebrum, the entire cere- 
bellum, and that part of the medulla which connects with the 
spinal cord, all of which sustain intimate relations to vital 
conditions. Accordingly, such a development indicates good 
digestion, active nutrition, vigorous secretion, large heart and 
lungs, powerful muscles and surplus vitality. The violent facul- 
ties, such as Combativeness, Destructiveness, Restlessness, Loco- 
motion and Hatred are natural adjuncts, and their excess tends 
to sensuality and crime. They are not only secretive, appro- 
priative, selfish and self-defensive, but when redundant are 
aggressive and tend to destructiveness, the gratification of ani- 
mal indulgence, intemperance and debauchery. The corres- 
pondence between the cerebral conformation and the physical 
development, is very obvious. Lower orders of animals possess 
these faculties, and their spontaneous exhibition is called instinct. 
They possess the acquisitive, destructive and propagating pro- 
pensities, which lead them to provide for their wants, and secure 
to themselves a posterity. The exercise of their bodies causes a 
continual waste which demands incessant reparation, and they 
are governed measurably by these animal impulsions. 
207. All of these lower psychical faculties have a physiologi- 
cal significance. Acquisitiveness expresses f unctionally, assimi- 
lation, accretion, animal growth, and tends to bodily repletion. 
Secretiveness expresses concealing, separating, withdrawing and 
functionally signifies secernent action. Secretion is separating 
and withdrawing from the blood some of its constituents, as 
mucus, bile, saliva, etc. This latter process indicates complex con- 
ditions of organization, so that the higher and more involved the 
texture, the greater the number of secretory organs. Unre- 
strained selfishness, while it naturally conserves the individual 
interests, in its ultimate tendencies, is the very essence of human 
depravity. Without qualification, clearly, it is crime, for blind 
devotion to an individual must be in utter disregard of the good SANGUINE TEMPERAMENT. 
163 
of others. The ultimate tendencies of these faculties are, there- 
fore, criminal. 
Depress the function of acquisitiveness, and it represents 
avariciousness. Lower secretiveness and selfishness, and they 
become cunning and profligacy, desperation and crime. Their 
functional reduction tends to produce physical disorder and vio- 
lent disease. All of these faculties are vehement, contending, 
thriving by opposition. Life itself has been called a forced 
state, because it wars with the elements it appropriates, and 
transmutes their powers into vitality. 
208. A slight preponderance or the sanguine elements, is very 
favorable to the constitution. We find many men and women of 
this temperament, who are models of character and of organiza- 
tion. George Washington is an excellent illustration. The 
impression that his presence made upon the Marquis of Chas- 
tellet, is given in the following words: “ I wish only to express 
the impression General Washington has left on my mind; the 
idea of a perfect whole, brave without temerity, laborious with- 
out ambition, generous without prodigality, noble without pride, 
virtuous without severity.” Gen. Scott, Lord Cornwallis, Dr. 
Wistar, Bishop Soule, John Bright, M. P., Jenny Lind Gold- 
smidt and Dr. Gall, are good 
representatives of this tem- 
perament. Fig. 85 is an ex- 
cellent illustration of it, finely 
blended and well balanced in 
the person of Madame de Stael. 
This temperament requires less 
tonics and stimulants than the 
lymphatic, and the mercurial 
preparations are contra-indi- 
cated in both. This constitu- 
tion is best able to restore vital 
losses, and has borne remark- 
ably well, the sanguinary prac- 
tice of blood-letting, which was 
formerly so popular with the 
medical profession. It is a vital 
temperament, i. e., combines favorably with all the others, and 
Fig. 85. 164 
COMMON SENSE MEDICAL ADVISER. 
better adapts itself to their various conditions. Some regard it 
as the best adjusted one in all its organs and tissues, and as the 
most satisfactory and serviceable. 
209. Excess of nutrition — rich blood — tends to plethora, to 
animal indulgence and gross sensuality. Not only do the pro- 
pensities rouse desire, but excite the basilar faculties, and they 
portray their wants in the outlines of the face, mould the features 
to their expression, and flash their significance from the eye. Who 
need mistake the picture of sensuality represented by Fig. 86. 
It is enough to shock the sensi- 
bility of a dumb animal, and to 
say that such a face has a beast- 
ly look, is an unkind reflection 
upon the brute creation. A 
large neck and corresponding 
development of the occipital 
half of the brain indicate ner- 
vous energy, yet nutrition is not 
absolutely dependent upon it, 
for the nutritive processes are 
active before a nervous system 
is formed. The lower faculties 
of the mind exert a remarkable 
influence over nutrition, secre- 
tion and the molecular changes 
incident to life. Anger, or fear, 
may transmute the mother’s 
nourishing milk into a virulent poison.- The following incident 
taken from Dr. Carpenter’s Physiology, illustrates this state- 
ment: “A carpenter fell into a quarrel with a soldier billeted in 
his house, and was set upon by the latter, with his drawn sword. 
The wife of the carpenter at first trembled from fear and terror, 
and then suddenly threw herself furiously between the combat- 
ants, wrested the sword from the soldier’s hand, broke it in pieces, 
and threw it away. During the tumult, some neighbors came in 
and separated the men. While in this state of strong excite- 
ment, the mother took up her child from the cradle, where it 
lay playing, and in the most perfect health, never having had a 
moment’s illness; she placed it to her breast, and in so doing, 
Fig. 86. SANGUINE TEMPEKAMENT. 
165 
sealed its fate. In a few moments the infant left off nursing, 
became restless, panted and sank dead upon the mother’s bosom. 
The physician, who was instantly called in, found the child lying 
in the cradle, as if asleep, and with its features undisturbed; but 
all his efforts at restoration were fruitless. It was irrecoverably 
gone. In this interesting case, the milk must have undergone a 
change, which gave it a powerful sedative action upon the sus- 
ceptible nervous system of the infant.” 
210. Anxiety, irritation, hatred, all tend to vitiation of the 
disposition, and bodily functions, perverting the character and 
constitution at the same time. Depravity of thought and of 
secretion, go together. Degradation of mind and corruption of 
the body, are concomitants. There is a very close affinity be- 
tween mental and moral perversion, and physical prostitution, of 
which fact, too many are unconscious. Nervous influence pre- 
serves the solubility of the blood and facilitates its circulation. 
We learn this from experiments, for it appears that simple ar- 
restment of this influence favors the coagulation of the blood in 
its vessels; clots being found in its trunks within a few minutes 
after the brain and spinal marrow are broken down. Habitual 
constipation is the source of many ills. Perversion of the func- 
tions of the stomach, and of the circulation of the blood, produce 
general disaster. 
211. Diseases which characterize this temperament are acute, 
violent or inflammatory, indicating repletion, and active conges- 
tion; intense inflammation, burning fevers, severe rheumatism, a 
quick, full pulse, great bodily heat and functional excitement are 
its morbid concomitants. These diseases will bear thorough 
depletion of the alimentary canal — active hydragogue cathartics 
fulfilling the indication. Nervous sedatives, capillary tonics and 
anodynes are als<5 essential, to modify, change and control the 
circulatory forces. Violent disturbance must be quelled, and the 
remedial police force required for this duty will include Veratrum, 
Ipecac, Digitalis, Opium, Lobelia, Conium, and Asclepias; the 
latter is usually the most serviceable of them all for encouraging 
the redistribution of the blood. We would not omit from this 
class of remedies Aconite, Gelseminum, the Calabar Bean, Alka- 
line treatment, Bathing, etc., as well as various disinfectants, 
which arrest the action of morbid materials in the blood. While COMMON SENSE MEDICAL ADVISER. 
equalizing the circulatory fluids, restoring the secretions and 
thoroughly evacuating the system and thus endeavoring to re- 
move disturbing causes, we find that the conditions of this tem- 
perament are exceedingly favorable for restoration to health. 
True, many chronic diseases are obstinate, dogmatically set and 
desperately resisting, yet a course of restorative medication per- 
sistently followed, promises a fortunate issue in this elastic and 
tractile temperament. 
212. Hygienic management of the lymphatic and sanguine 
temperaments consists in the vigorous toning of the former, while 
restraint of the latter will greatly exempt it from the anxieties, 
contentions and vexations which excite the mind, disturb the 
bodily functions, and end in chronic disease. People of the lat- 
ter organization love mental and physical stimulus, are easily 
inflamed by passion, and their excitability degenerates into 
irritability, succeeded by serious functional derangements, which 
prematurely break down the individual with inveterate, deep- 
seated disorder. Serenity, hope, faith, as well as firmness are 
natural hygienic elements. It is a duty we owe the health to 
promptly relinquish a business that corrodes with its cares, and 
depresses with its increasing troubles. Constant solicitude, and 
the apprehension of financial disaster, will frustrate the bodily 
functions, disconcert the organic processes and lead to mental 
aberration as well as physical degeneracy. Melancholy is chronic, 
while despair is acute mania, whose impulses drive desperately 
towards self-destruction. The chronic derangement of these 
organs exerts with less force the same morbid tendency, subver- 
sive of life. Hence the necessity for exercising those hygienic 
and countervailing influences born of resolution, assurance and 
confident trust, and the belief in which, strengthens all of the 
vital operations. 
213. Doubtless, this temperament is the source of the repro- 
ductive powers. It is the corner stone, essential to the foundation 
of all other temperaments. Formerly, it was the supposition that 
the cerebellum was the seat of sexual instinct, but latterly, this 
is greatly discredited. The fact appears, that an ample develop- 
ment of the posterior base of the cerebrum and the cerebellum 
indicates nutritive activity, which is certainly a condition most 
favorable to the display of amativeness. In a double sense then, THE LIFE LINE. 
167 
this temperament is a vital one; both by nutritive repletion, and 
by reproduction. It is the blood-manufacturing, tissue-genera- 
ting, and body-constructing temperament, causing growth to 
exceed waste, and promptly repairing the wear which follows 
continual labor. 
While the sleazy structures of the lymphatic temperament are 
favorable to the functions of transudation, exhalation and mutual 
diffusion of liquids, the sanguine, as its name indicates, is adapted 
to the circulation of the blood, to nutrition and reproduction. 
Although the former temperament does not move the world by 
its energies, or impress it vividly with its wisdom, yet the latter, 
is more enthusiastic, enjoyable and quickening. Each tempera- 
ment, however, possesses salient qualities and advantages. 
THE LIFE LINE. 
214. Dr. W. Byrd Powell, in his work on “The Human 
Temperaments,” announces the discovery of a measurement, 
which indicates the tenacity of life, and the vital possessions of 
the individual. He observed that some persons of very feeble 
appearance, possess remarkable powers of resistance to disease 
and continue to live until the machinery of life, literally wears 
out. Others, apparently stronger- and more robust, die before 
the usual term of life is half completed. He also noticed, that 
some families were remarkable for their longevity, while others 
reached only a certain age, less than the average term of life, and 
then died. He remarked also, that some patients sank under at- 
tacks of disease, when to all appearances, they should recover, 
and that others recovered, when, agreeably to all reasonable cal- 
culations, they ought to die. He therefore, not only believed 
that the duration of human life was more definitely fixed by the 
organization than was supposed, but he set himself the task to 
discover the line of that life and the measure of its duration. 
He made a distinction between vital vigor, and vital tenacity, 
viz: vital vigor is equivalent to the condition of vitality, 
which is indicated by breadth of the brain, corresponding to 
sanguine development; and vital tenacity, measured by the 
depth of the brain’s base. Dr. Powell was an indefatigable 
student of nature, and followed this theory through years of 
observation, and in the measurement of hundreds of heads of 168 
COMMON SENSE MEDICAL ADVISEE. 
living persons, m order to verify the correctness of the hypothe- 
sis. His method of measuring the head may he stated as follows: 
He drew a line from the occipital protuberance on the hack of the 
head, to the junction of the frontal and malar bones, extending 
it to a point above the center of the external orbit of the eye, 
near the termination of the brow. Now measure the distance 
between this line and the orifice of the ear, and we have the 
measure indicating the vital tenacity or duration of life. The 
accompanying Fig. 87 is a representation of the skull of Loper, who 
was hung for murder, in Mississippi. He might have attained 
a great age, had not his violent 
and selfish faculties led him 
into the commission of crime. 
In this illustration, B represents 
the occipital protuberance, and 
A the junction of the frontal 
and malar bones at the exter- 
nal angle of the eye. The dis- 
tance between this line (A B) 
and the external orifice of the 
ear, is the measure of the life- 
force of Loner, at the time of his execution. 
Fig. 87. 
215. The tenacity of an individual’s life, Dr. Powell deter- 
mined by the following scale of measurements. Three-fourths 
of an inch from the orifice of the ear to the life-line, is the 
average length in the adult, and indicates ordinary tenacity of 
life. As the distance decreases to five-eighths, one-half, three- 
eighths, vital tenacity diminishes. If the measure is more than 
three-quarters of an inch, it denotes great vital endurance, ex- 
cellent recuperative powers, and is indicative of longevity. If 
it measures less than a half inch, it shows that the constitution 
has a feeble, uncertain hold upon life, and an acute disease is 
very likely to sunder the vital relations. 
216. Dr. Powell contended that, “ life force and vital force are 
not equivalent terms, because much more vital force is expended 
upon our relations, than upon our organization in the preserva- 
tion of life. Every muscular contraction, every thought and 
every emotion requires an expenditure of vital force.” He taught 
that we inherit our life force, or constitutional power, and that VOLITIVE TEMPERAMENT. 
we can determine by this life-line, the amount which we so re- 
ceived. And he believed that it can be improved by intellectual 
effort, just as we can improve vital force by 'physical exercise. 
Fig. 88 represents the skull of a man who died, at nearly the 
same age as Loper, of comsumption, in the Charity Hospital, at 
New Orleans. The measure- 
ment of the skull in this case, 
. ’ 
gives a space between the life- 
line and the orifice of the ear, 
of one-sixteenth of an inch* 
showing that the consumptive 
had lived the full term of his 
life. Dr. Powell contended 
that the depth of a man’s 
brain may be increased after 
maturity; muscular effort, 
mental activity, and a sense 
of responsibility being favorable to longevity, while idleness and 
dissipation are adverse to it. In justice to the Doctor, we have 
stated fully his theory and his method of determining the hardi- 
hood and endurance of the constitution, and we bespeak for it a 
candid examination. Without doubt it embodies a good deal of 
truth. Hereafter we shall endeavor to indicate by cerebral con- 
figuration, a better system of judging of the vital tenacity, 
hardihood and constitutional energies, both inherited and acquired. 
Fig. 88. 
THE VOLITIVE TEMPERAMENT. 
217. By reference to Figs. 71 and 79, the reader will be able 
to locate the region of the volitive faculties, previously described 
under the generic term, will, 164. This temperament is 
characterized by ambition, energy, industry, perseverance, deci- 
sion, vigilance, self-control, arrogance, love of power, firmness 
and hardihood. These faculties express concentration of pur- 
pose, and their f unctional equivalents are power of elaboration, 
constructiveness, condensation, firmness of fiber, compactness of 
frame and endurance of organization. The pulse is full, firm 
and regular, the muscles are strong and well marked, hair and 
skin dark, the temporal region is not broadly developed, the face 
angular, its lines denoting both power of purpose and strength 170 
COMMON SENSE MEDICAL ADVISER. 
of constitution, with resolution and hardihood blended in the 
expression. The volitive temperament is distinguished by height 
of the posterior superior occipital region, called the crown of the 
back head, and by corresponding breadth from side to side. The 
rule given by Dr. J. R. Buchanan applies not only to the con- 
volutions, but to the general development, of the brain, viz: 
length gives poicer, or range of action, and breadth gives 
copiousness, or activity of manifestation. Thus a high, narrow 
back head indicates firmness and decision, but it is not as con- 
stant and copious in its manifestation as when it is associated 
with breadth. An individual having a narrow, high head, may 
determine readily enough upon a course of action, but he will 
require a longer period for its completion, than one whose head 
is both high and broad. Such a cerebral conformation cannot 
accomplish its objects without enjoying regular rest, and main- 
taining the best of habits. Breadth of this region of the brain 
indicates ample resources of energy, both psychical and func- 
tional. It denotes greater vigor of constitution, one that con- 
tinually generates volitive forces, and its persistency of purpose 
may be translated as functional tenacity. Cerebral retentiveness 
signifies physical cohesiveness, and psychological adhesiveness is 
physiological constancy, i. e., inflexibility of will and purpose 
impart their tenacious qualities to every bodily function. These 
are really the governing faculties, not only directing the volun- 
tary functions, but exerting a vigorous and efficient influence 
upon the ganglionic nervous system. The will to recover is often 
far more potent than medicine, and we have many times seen its 
power in restraining the ravages of disease. These energetic 
faculties, located at the upper and posterior part of the head, are 
the invigorating, or tonic elements of the constitution, imparting 
hardy, firm, steady and efficient influences, checking excess of 
secretion, repressing dissipation, and tending to maintain self- 
possession, as well as healthy conditions of life. We present the 
likeness of President Ulysses S. Grant (see Fig. 89) which shows 
a well balanced organization, with sufficient volitive elements to 
characterize the constitution. 
218. The old name — Bilious Temperament — might possibly 
be retained in deference to long usage, did it not inculcate a 
radical error. Bilious, is strictly a medical epithet, relating to VOLITIVE TEMPERAMENT. 
171 
bile, or to disorders arising in consequence of its superabundance, 
and it was applied originally 
to distinguish a temperament 
supposed to be characterized 
by a predominance of the liver 
and biliary secretion. Physi- 
cians well understand now, 
that a copious biliary secre- 
tion has a prostrating effect 
upon the constitution, and that 
a predominance of the liver is 
associated with the lymphatic 
temperament. In the volitive 
temperament, the firm, tena- 
cious, toning and restraining 
faculties, repress, rather than 
encourage biliary secretion, 
and hence the necessity for 
administering large doses of 
cathartics, and using cholagogue (bile-driving) medicines. When 
the system is surcharged with bile and the liver needs a powerful 
stimulus to excite it to duty, then it is that we use these agents 
in order to obtain necessary relief, often attended however, with 
prostrating effects. In this temperament, there is moderate he- 
patic development, lack of biliary activity, deficiency of the secre- 
tion of bile and a sluggish, portal circulation (see 54). Therefore 
to apply the term bilious, to this temperament, is not only un- 
reasonable and a misnomer, but it is calculated to mislead as to 
facts. The condition of the bowels is generally constipated, the 
skin dark and sometimes sallow, indicating hepatic torpor. For 
these and other obvious reasons, we dismiss the word bilious, and 
substitute one which is more characteristic. 
Fig. 89. 
219. We will not dwell upon the volitive as psychical organs, 
except to show that when their influence is transmitted to the 
body, they act as physiological organs, and thus illustrate that 
all parts of the brain have their physiological as well as mental 
functions. When President Andrew Jackson uttered with ter- 
rible emphasis the memorable words, “by the eternal,” the 
effect was like a shock from a galvanic battery, thrilling the cells 172 
COMMON SENSE MEDICAL ADVISER. 
in his own body, and palsying with fear, every one in Calhoun’s 
organization. This is an illustration of the power, or range of 
action of these faculties. Breadth or copiousness, is illustrated 
Fig. 90. 
in Gen. Grant’s reply, “ I propose to eight it out on this line, 
if it takes all summer.” Such a temperament lias a profusion 
of constitutional power, great durability of the life-force, and in 
our opinion, the combined height and breadth of this region, VOLITIVE TEMPERAMENT. 
173 
correctly indicate the natural hardihood of the body and its 
retentiveness of life. No one need doubt its influence upon the 
sympathetic system, and through that system, its power over 
absorption, elaboration, nutrition, circulation, assimilation and 
secretion, as well as the voluntary processes. Mental hardihood 
seems wrought into concrete organization. It checks excess of 
glandular absorption, restrains the impulses of tumultuous passion, 
tones and regulates the action of the heart, and helps to weave 
the strands of organization into a more compact fabric. The 
toning energies of the volitive faculties are better than Quinine to 
fortify the system against miasms,— infectious emanations from 
living or dead bodies — against malaria,— morbific agents arising 
from the earth, stagnant water, etc., — and they co-operate with 
all tonic remedies in sustaining organic action, and durably aug- 
menting the tension of all the solids. Fig. 90 represents Prof. 
John Tyndall, the eminent chemist, whose likeness indicates 
volitive innervation, showing great strength of character and of 
constitution; he is an earnest, thorough, and intense mental 
toiler, ambitious but modest, brilliant because persevering, 
diligent in scientific inquiry, who follows the star of truth, 
whithersoever it may lead him. The expression of his coun- 
tenance indicates his honest intentions, and displays strength of 
conscientious purpose; his physical constitution maybe correctly 
interpreted in all of its general characteristics by the analysis of 
his energetic temperament, the great secret of his strength and 
success. 
220. We desire to offer one more illustration of a marvelous 
blending of this temperament with large mental and emotional 
faculties. Fig. 91 is a representation of the martyred President, 
Abraham Lincoln. During an eventful career, his temperament 
and constitution experienced marked changes, and while always 
distinguished for strength of purpose and corresponding physical 
endurance, he was governed by noble, moral faculties, manifest- 
ing the deepest sympathy for the down-trodden and oppressed, 
blending tenderness and stateliness without weakness, exhibiting 
a human kindness and displaying a genuine compassion, which 
endeared him to all hearts. He was hopeful, patriotic, magnani- 
mous even, while upholding the majesty of the law and admin- 
istering the complicated affairs of government. The balances of 174 
COMMON SENSE MEDICAL ADVISEE. 
his temperament operated with wonderful delicacy, through all 
the pertubating influen- 
ces of the rebellion, show- 
ing by their deflection 
that he was never for a 
moment turned aside 
from the great end he 
had in view, viz: the 
protection and perpet- 
uation of republican 
liberty. His life ex- 
hibited the efferent in- 
nervations, or out-going 
impulsions of equity, lib- 
erty, and a sublime, mor- 
al heroism, elements of 
character which hallow 
his name, and embalm 
it in everlasting remem- 
brance. 
221. We have treated the brain, not as a mass of organs 
radiating from the medulla oblongata as their real center (which 
is simply a trophic center), but as two cerebral masses, each of 
which is developed, as the radii of a sphere, around the great 
ventricle. We have freely applied an easy psychical and physi- 
ological nomenclature to the functions of its organs, knowing 
that there is no arbitrary division of them by specific number, for 
the cerebrum, in an anatomical sense, is a single organ. The 
doctrine of cerebral unity is true, and the doctrine of its plurality 
of function, is true also. Whatever effect an organ produces 
when acting in entire predominance, is regarded as the function 
of that organ and is expressed by that name. Although our 
names and divisions are arbitrary and designed for convenience, 
yet they facilitate our consideration of psychical, and their cor- 
responding physiological, functions. Every cerebral manifesta- 
tion denotes a psychical organ, and in proportion as these acts 
are transmitted to the body, it becomes a physiological organ. 
We have ventured to repeat this proposition for the sake of the 
non-professional reader, that he may be able to distinguish 
Fig. 91. ENCEPHALIC TEMPERAMENT. 
175 
between the two results of the manifestation of one organ. The 
transmission of the influence of the brain into the body, enables 
the former to act physiologically, whereas, if its action were 
confined within the cranium, it would only be psychical. In the 
language of Prof. J. R. Buchanan, “ every organ, therefore, has 
its mental and corporeal, its psychological and physiological 
functions — both usually manifested together — either capable of 
assuming the predominance.” We have already seen to what 
degree the Will operates upon the organism, or how (to express 
it strictly in religious dialect) “ the soul imparts special energy to 
single organs, so that they perform their functions with more 
than usual efficiency,” and thus resist the solicitations of mor- 
bific agents. Doubtless our best thoughts are deeply tinged by 
the healthful or diseased conditions of such organs as the stomach, 
the lungs, the heart, the nerves or even the muscular and circu- 
latory systems, and these impressions Avhen carried to the sen- 
sorium, are reflected by the thoughts, for reflex action is the 
third class of functions, assigned to the cerebrum (see 131). 
These reflex actions are, either hygienic and remedial, or morbid 
and pernicious. Hence, it is philosophical not only to interpret 
the thoughts as physiological and pathological indications, but 
to consider the cerebrum as exerting real hygienic and remedial 
forces, capable of producing salutary, reparative and potently 
restorative effects. When an engine carries more steam than 
can be advantageously employed, it is subjected to unnecessary 
and injurious strain, and is weakened thereby; so when the body 
is overtasked by excessive pressure of the volitive faculties, it is 
prematurely enfeebled and broken down. There are many indi- 
viduals who need to make use of some sort of safety valve to let 
off the surplus of their inordinate ambition; they need some kind 
of patent brake whereby to slacken their speed of living; they 
should relieve the friction of their functional powers by a more 
frequent lubrication of the vital movements, arid by stopping, 
for needed refreshment and rest, at some of the many way- 
stations of life. 
THE ENCEPHALIC TEMPERAMENT. 
222. The encephalic temperament is distinguished by promi- 
nence and breadth of the forehead, or by a full forehead associated 176 
COMMON SENSE MEDICAL ADVISEE. 
with height and breadth at its coronal junction with the parietal 
bones, and extending toward’the volitive region. (See Fig. 10, 
the space between 1 and 2 represents the coronal region, 1 indicat- 
ing the frontal bone, and 2 the parietal). Prominence and great 
breadth of the forehead display analytical, i. e., scientific powers 
applicable to concretes, whereas a fair intellect, associated with 
a preponderating development of the coronal region, indicate 
analogical powers, i. e., facilities adapted to similitute, relation 
and the agreement of principles. The former classifies and 
arranges facts, the latter invests them with moral and spiritual 
import. The one treats of matter, its physical properties and 
chemical composition, the other, of thoughts and intentions 
which involve right and wrong, relating to spiritual accounta- 
bility. The intellect is employed upon an observable order of 
things, while the emotive faculties arrange the general laws of 
being into abstract science. 
223. Fig. 92, an illustration of Prof. Tlioluek, is a remark- 
able example of an encephalic organization. Figs. 71 and 
78 fairly indicate the effects of 
undue mental activity, the intel- 
lect causing vital expenditure, 
and the emotions resulting in 
the devitalization of the blood, 
by exhausting its animus. While 
the intellect displays keen pene- 
tration, subtle discrimination and 
profound discernment, the emo- 
tions exhibit intense sensitiveness, 
acute susceptibility and inspira- 
tional impressibility. Evidently, 
such transforming powers, which 
change the equivalents of vitality 
into ideas and spiritual impres- 
sions, execute their functions by 
means of nerve cells, each one a 
parasite, to suck up the life of the blood. Each upward trans- 
formation is given back to Nature in its downward metamorphosis. 
Fig. 92. 
224. The encephalic temperament is characterized by mental 
activity, great delicacy of organization, high and broad forehead, ENCEPHALIC TEMPEKAMENT. 
177 
expressive eyes, fine but not very abundant hair, great sensitive- 
ness, refined feelings, vividness of conception and intensity of 
emotion. If the brain be laterally developed, there is manifested 
Ideality, Modesty, Sublimity, Imagination and Spirituality. If 
the brain and forehead project, the Perceptive, Intuitive and 
Reasoning faculties will predominate. If it rises high, and nearly 
perpendicularly, Liberality, Sympathy, Truthfulness and Socia- 
bility are manifested. If the emotive faculties are large, Faith, 
Hope, Love, Philanthropy, Religion and Devotion will character- 
ize the individual. It is an artistic, creative, and esthetic tem- 
perament, beautiful in conception and grand in expression, yet 
its sensitiveness is enfeebling, and its crowning excellence —Love 
— when betrayed by the propensities, trails in defilement. Its 
purity is God-like, its debauchment, Perdition ! Fig. 93 repre- 
resents Alexander Wilder, M. D., of New York City, not as 
Fig. 93. 
perfectly as we could wish, but it truthfully portrays his mas- 
sive intellect, and the blending of the encephalic with moderate 
volitive faculties. lie possesses an analytic mind, acute in his 178 
COMMON SENSE MEDICAL ADVISER. 
observations, forcible in bis expressions and vivid in his concep- 
tions. Although very sensitive in his organization, yet he faith- 
fully obeys the mandates of truth, cost what it may. lie is tall 
and spare in his person, and his height, intellectually speak- 
ing, allows him a broader vision for scientific synthesis, and he 
might become distinguished as a moral philosopher. 
Fig. 94 is the likeness 
of Prof. George Bush. 
His forehead is amply de- 
veloped in the region of 
Foresight, Liberality, Sym- 
pathy, Truthfulness and 
Benevolence; his mouth ex- 
presses Amiability and 
Cheerfulness, and the whole 
face beams wdth Kindness 
and Generosity. This phi- 
lanthropist, who is both a 
preacher and an author, has 
published several works 
upon theology, which dis- 
tinguish him for great re- 
search and originality. 
225. Fig. 95 represents 
the sanguine - encephalic 
temperament, the two ele- 
ments being most happily blended. The portrait is that of 
Emanuel Swedenborg, the great scholar and spiritual divine. 
The reader will observe how high and symmetrical is the fore- 
head, and how well balanced appears the entire organization of 
this great Seer. He is remarkable for vivid imagination, vast 
scientific and emotional resources, and all his writings char- 
acterize him as a subtle reasoner, profoundly versed in the 
sublime mysteries of spirituality. 
226. Every bright thought, and every noble aspiration, born 
out of organic materials and conditions, are transformed by the 
functional processes of the brain. We are gradually learning 
that the scale of human life is evenly poised by equivalents. The 
rise of one arm of the balance, indicates the fall of the other, 
Fig. 9J{.. ENCEPHALIC TEMPERAMENT. 
179 
and every thought or emotion disturbs the equilibrium, for its 
liberation sends an equivalent of brain and blood-substance back 
to decomposition. If the highest manifestation of organic force 
is Spirituality, the brightest sparkle of truth or the most refulgent 
Fig. 95. 
glow of emotion, leaves an equation of disrupted elements — the 
ashes of its mortality. Critical analysis, summoning the facul- 
ties of the intellect, makes fearful raids upon the blood, plunder- 
ing its nourishment, expending its vital energies, and stealing its 
richest qualities to form the texture of thought. Slowly, day by 
day and hour by hour, study impoverishes it by taking its glow, 
appropriating its richness and leaving it pale, cold and languid. 
The unsteady nerves tremble with St. Yitus dance, the skin is 
blotched with scrofula, rickets distort the bones, and wan con- 
sumption displays a sickly whiteness, the sure foretoken of 180 
COMMON SENSE MEDICAL ADVISER. 
approaching dissolution. Oft has paternal gratitude uttered: 
“We thank Thee, most merciful God, for the new-born blessings 
which Thou sendest into the arms of father and mother, to gladden 
not only them, but likewise relative and friend, and to people the 
earth with new generations of progressive men.” The fond 
parent watches for the faintest glimmer of intelligence, reflected 
from this immortal gem, and straightway builds a paradise of 
hopes. These scions of love, however, are rendered too delicate 
for earth, for instead of cultivating and improving their bodies, 
we early consecrate them to wasting thought and emotion, until 
particle by particle, and by vital equivalents, mortality yields 
them a spiritual oblation. The stricken parents now pray: “O 
Thou Infinite Father, we thank Thee that for all sorrows there 
is a balm and relief, that the world which arches over our heads, 
invisible to mortal eye, is yet but a step from us, and our dear 
ones, looking their last on earth, are born anew into Thy kingdom 
above; in Thy mysterious and afflictive providences, increase 
our trust that we may be able to say, ‘Thy will be done.’” 
Heaven comes near to earth and opens to the eye of faith celes- 
tial visions. But truth must enlighten the understanding in 
order that parents may know more concerning the rearing and 
culture of their children, and especially, how to strengthen their 
bodies for functional endurance, to the end, that they may attain 
both usefulness and length of days. The helplessness of the 
child suggests the nursery for its incipient care and prudent cul- 
ture, which afterwards is supplemented by common schools and 
universities for intellectual, and by churches and theological 
seminaries for moral and spiritual development. Physical train- 
ing, for healthful discipline, is the foundation on which to build, 
for there can be no durable, intellectual or moral superstructure 
without it. Let parents be diligent in laying carefully a solid 
foundation for the child in bones, muscles, rich blood and good 
health, by providing proper food, sufficient clothing, abundance 
of pure air, regular exercise and hygienic habits, and then good 
moral culture is all that will be required to complete a respecta- 
ble, useful and magnificent man. He who would erect a great 
tower and hang a huge bell, upon an edifice which of itself is 
diminutive, without regard to either proportion or foundation, 
will find his impracticable calculations a laughing-stock, and his ENCEPHALIC TEMPERAMENT. 
181 
architecture a failure. Unless the encephalic temperament is 
vigorously sustained by volitive energies and abundant sanguine 
offerings, it is, comparatively, useless architecture, attended by 
physiological misfortune and utter disaster. 
227. When the encephalic preponderates and the sanguine is 
deficient in its elements, we find conditions favorable to waste 
and expenditure, and adverse to a generous supply and reforma- 
tion of the tissues. A child, inheriting this cerebral development 
is already top-heavy and supports, at an immense disadvantage, 
this disproportionate organization, very much as a man carries 
a mortgage, the interest on which exceeds his income. The 
nutritive functions are overbalanced, consequently, there is 
an insolvent diathesis, a predisposition to scrofulous diseases, 
disorders of the blood, various degenerating changes taking 
place in its composition; loss of red globules signified by short- 
ness of breath, morbid changes, manifested by cutaneous diseases 
and cancerous humors, exhaustion from lack of nourishment, 
etc., until finally, consumption winds up the affairs in complete 
bankruptcy. 
228. Harmony is the support of all institutions and applies 
with special cogency to the maintenance of health. If the mind 
dwells on one subject to the exclusion of all others, we call it 
mono-mania. If we have an excessive development of mind, and 
deficient support of body, the result is corporeal derangement. 
It is unfortunate for any child to inherit unusual encephalic en- 
dowments, unless he is in possession of a vigorous, robust con- 
stitution. Such training must be directed to that body as will 
encourage it to grow strong, hearty and thrifty, and make it 
equal to the support of the cerebral functions. It is needful to 
check the mental proclivities, and cultivate the physical organiza- 
tion, to insure to such a child the harmony of health. Cut off 
all unnecessary brain-wastes, attend to muscular training and 
such invigorating plays and exercises as encourage the circula- 
tion of the blood, keeping the skin clean and its functions active, 
the body warm and well protected, the lungs supplied with pure 
air, the stomach furnished with wholesome food, plenty of sleep 
to invigorate the system, and thus, by regular habits, maintain 
that equilibrium which tends to wholesome efficiency and health- 
ful endurance. 182 
COMMON SENSE MEDICAL ADVISER. 
TRANSMISSION OF LIFE. 
229. In our introduction to temperaments, we endeavored 
briefly to say, that healthful reproduction depends upon vital 
stimuli and vital susceptibilities. That these two conditions 
are bisexous, stimulus belonging to the male, and susceptibility 
to the female, organization. That unlikeness of derivation — 
essential difference of parental constitution — tends to fertility. 
Parallelism of organization — similarity of natures — tends to 
barrenness. Breeding in and in, i. e., family intermarriages, 
diminish vigor and fertility. The temperaments indicate unlike 
conditions — contrasts of molecular constitution — needful for 
producing the fruitful germs of new individuals. Two persons, 
male and female, may possess a combination of organic elements 
so uniformly similar, that stimuli and susceptibility are lost. 
There is such uniformity of organization, similarity of parts and 
sameness of elements, such a homogeneity of conditions and 
nature, that their state is one of entire agreement. And we call 
this perfect physical concordance, incompatibility ! On no other 
hypothesis can we explain the sterility between parties, either 
of whom would have been fertile with different organizations. 
Both represent vital conditions, but they are not adapted to each 
other and are thereby rendered infertile. Napoleon Bonaparte 
and his first wife, Gen. Washington and wife, Gen. Jackson and 
wife, are familiar illustrations of this truth. Either of these 
might have been life-generating with other parties. A critical 
analysis of their temperaments has resulted in the conclusion 
that their constitutional similarity, was the occasion of their 
infertility. 
230. Between certain combinations of temperaments this sex- 
ual indifference is lost, and there is an irrepressible aptitude to fe- 
cundation, the result of functional attractions and antagonism of 
temperaments. Every year we witness such physical and mental 
attractions between the sexes, wholly unaccountable to ordinary 
philosophy. Out of these differences of organic disposition, 
which seem so contradictory and unpromising, is transmitted a 
vigorous and healthful progeny. The mystery is, how can indi- 
viduals so dissimilarly tempered, blend in physical and spirit- 
ual coaptation, unless they are unconsciously moved by vital TRANSMISSION OF LIFE. 
183 
attractions. The temperaments may be likened to a magnet, 
the like poles of which repel, and the unlike, attract each other. 
So similarity of temperament is infertility, while dissimilarity 
makes the vital magnetism all the more powerful. Marriageable 
parties, moved, they hardly knew how, or by what influence, 
have been drawn instinctively toward each other, have taken 
upon themselves the vows and obligations of wedlock, and have 
been fruitful and happy in this relation. Unholy alliances, 
founded upon position, money or purely ai*bitrary considerations 
— mere contracts of convenience — are very apt to prove joyless 
and unproductive. 
231. Mankind may unconsciously obey strong temperamental 
attractions without even a suspicion of their existence, and in 
doing so, avoid those ills, which otherwise might destroy their 
connubial bliss. The philosophy of marriage receives no con- 
sideration, because the mind is pre-occupied with newly awakened 
thoughts and feelings. Lovers are charmed by inaudible har- 
monies, feel interior persuasions, respond to a new magnetic field, 
and are generally lost in an excess of rapture. Cupid is the 
divinity who excites the love that binds together human kind; 
and yet this fickle deity, with averted eyes, golden wings and 
quiver, is suffered to act like a mischievous, wanton boy, from 
whose tricks neither gods nor men are safe ! He comes too 
often, only in the hours of darkness and flies before the dawn of 
morning, inspiring passion with his words of love ! We propose 
that his habits shall be more regular and his visits made when 
suspicion need not attend the sportive youth ! In works of art 
Psyche is represented as a maiden with the wdngs of a butterfly, 
the companion of Cupid, and Milton thus alludes to the twain : 
“ Celestial Cupid, her famed son, advanced, 
Holds his dear Psyche sweet entranced, 
After her wandering labors long, 
’Til free consent the gods among 
Make her his eternal bride; 
And from her fair unspotted side 
Two blissful twins are to he horn, 
Youth and Joy; so Jove hath sworn.” 
When Cupid learns temperamental adaptation with all his 
other arts, he will succeed physiologically in love conquests, and 184 
COMMON SENSE MEDICAL ADVISEE. 
have no need to journey through the aerial regions to supplicate 
the aid of Jupiter, nor will Psyche require the assistance of Mer- 
cury to make her happy in her nuptial relations. 
232. Under the head of incompatible combinations through 
similarity of temperaments, we classify the Sanguine Tempera- 
ment with another Sanguine Temperament, in which the organic 
elements seem to be held in equilibrium. If the constitution is 
characterized by Volitive elements, this should not unite with a 
temperament of the same diathesis. 
PHYSIOLOGICAL MARRIAGE. 
233. Physiological marriage results from the blending of the 
vital and non-vital temperaments. The Sanguine constitution 
will blend in functional harmony with the Encephalic tempera- 
ment, and with all of its minor and varying proportions of 
Arolitive and Lymphatic elements. The Encephalic is naturally 
its opposite, and consequently, is magnetically and vitally at- 
tracted to it. The Yolitive constitution will blend physiologi- 
cally, with its opposite, the Lymphatic temperament, combining, 
in different proportions, Sanguine and Encephalic elements. 
INCOMPATIBLE MARRIAGE. 
234. If the parties to a marriage are both non-vital, i. e., 
if the organic elements preponderate so that both are encephalic 
or lymphatic, the offspring will be short-lived, and subject to 
wasting diseases. If both parties are excessively lymphatic, 
and there should be issue, there will result an indolent constitu- 
tion with an inferior grade of vitality; the structures will be soft 
and yielding, easily influenced by morbid agencies. 
235. Similarity of person and sameness of temperament are 
conditions incompatible to healthful and vigorous offspring. If 
the parties to a marriage are evenly balanced in organic ele- 
ments, although both of them are vigorous, yet it is physiologi- 
cally more suitable for them to form a nuptial alliance with an 
unlike combination. If the marriage has in view healthful 
propagation, as well as mutual enjoyment of mental and physical 
attractions, a vital temperament should be united to one that 
possesses either encephalic or lymphatic characteristics. We 
have seen mothers who acted quite indifferent towards a daughter, CONJUGAL UNITY. 
185 
their perfect counterpart in body and disposition, and fathers 
take a seemingly secondary interest in the son who greatly re- 
sembled them. The child who is most unlike the parent, no 
matter how wayward and troublesome, will generally enlist the 
largest share of parental sympathy. 
236. The cause of the wretchedness attending many marriages, 
may be traced to a too great similarity of organization, ideas, 
taste, education, pursuits and association, which similitude almost 
invariably terminates in insipidity, and domestic unhappiness. 
No wonder that the off spring are tame, docile, languid, prosaic, 
and weak in mind and body. Husband and wife need to be as 
different as the positive and negative poles of a magnet, repre- 
senting vital and non-vital temperaments, the ordinary status of 
each being totally unlike the other in vital tension; when life is 
begotten under these circumstances, we may expect a develop- 
ment bright with intelligence, whose flashing thoughts and rever- 
berating forces will create a disturbance in the elements, for vital 
electricity means action and reaction, equal and opposite, just as 
the pendulum of a clock oscillates to and fro by the alternate 
influences of gravity and momentum. Every thought and act is 
only an equivalent given back, a shock from the battery of life 
and a release of power. 
In sameness of organisms there is but little stimulus, and hence 
there results a satiety which is not only unsatisfactory, but utterly 
devoid of pleasure. Unsuitable marriages always result unhap- 
pily, render the parties more liable to temptation and cause them 
to forget their solemn vows of conjugal fidelity. What a war 
follows between the absolute assertions of man’s higher and 
lower nature. No wonder that unhappiness with its nameless 
and numberless accompaniments, is the bitter experience of 
incompatible marriages. The union of parties who are closely 
allied in blood, if they are very dissimilarly tempered, does not 
necessarily entail degeneracy on their offspring. They are 
liable, however, to have the same predisposition, and hence are 
very likely to deteriorate. 
CONJUGAL UNITY. 
237. Real conjugal unity does not consist in rest, but in 
action, not in stagnation but agitation, not in insipidity, but in 186 
COMMON SENSE MEDICAL ADVISER. 
oppositeness. The parties to a marriage contract should repre- 
sent opposite conditions of temperament. Variations in func- 
tions and structure, (not race contradictions) promote fertility. 
The husbandman understands that mixing soils renders them 
more productive. The elements lacking in one constitution are 
supplied by the other. Who has not observed poor specimens 
of a splendid stock, issuing from healthy parents incompatibly 
united in marriage ? And likewise, who has not witnessed grand- 
children redeeming the original promise and character of a family, 
and restoring its abated forces, by a fortunate physiological 
alliance? Behind these outward relations there must exist 
different vital potencies adapted to temperamental variations. 
The strongest sexual attractions arise out of these variations and 
spiritual antagonisms. How intense, how all absorbing and 
vitalizing is love, which hallows the springs of life. How single, 
pure and undivided, and how loyal it is to monogamous relations, 
will be discussed in the following chapter. When this Divine 
institution is rightly undersood and appreciated, then may we 
better comprehend these words of Jesus: “What therefore, God 
hath joined together, let not man put asunder.” 
THE APPLICATION OF CEREBRAL PHYSIOLOGY 
AND TEMPERAMENTS TO THE SUCCESSFUL 
PRACTICE OF MEDICINE. 
238. The dew-drop on a blade of grass owes its rotundity and 
persistence to the action of a variety of forces. These are ex- 
erted in different ways, as the adhesion of the water to the leaf, 
the cohesion of the fluid particles among themselves, the attrac- 
tion of gravitation, the presence of a certain amount of moisture 
in the atmosphere, the prevalence of a given temperature, as 
well as many other conditions and incidental circumstances not 
enumerated. The dew-drop may evaporate under sunshine, the 
wind may blow upon, and dislodge it, thirsty vegetable absorb- 
ants may drink it up, and in the laboratory of organization it 
may enter into the chemistry of life, ascend as incense, disappear 
as aqueous vapor, come again with the thunders of the tempest, 
and finally reappear, transfigured in the colors of a flower. 
Change of condition is the order of nature. 
239. So it is with man. Mysteriously generated, developing PRACTICAL IDEAS. 
187 
according to conditions, subject to the laws of life, perpetually 
undergoing change by physical, chemical and vital forces, he is 
likewise subjected to agencies which derange his functions, 
weaken his constitution, and finally overwhelm him with disease. 
It is the physician’s duty to rectify these deviations from health 
by making favorable terms for functional duties, and endeavor- 
ing to restore each organ to its normal physiological relation. 
240. The analysis of*physiological functions, 
and of the temperaments, is also an analysis 
of diseased actions. In cerebral physiology, we indicated 
the mutual relations sustained by the nervous system, between 
the brain-functions and corporeal-functions. Unless we critically 
discern these reciprocal influences, how shall we know when they 
are disturbed, comprehend the dependence of one disordered 
action upon another and be prepared to regulate or remedially 
influence them. How are we to understand the connection of 
all the wheels of the machinery of life, or correct their move- 
ments, if their functions, relationship and dependence are a mys- 
tery ! All analysis of disease nmst be based on physiological 
knowledge. 
241. We refer the reader to the analysis of the cerebral 
functions and the human temperaments, which we have merely 
outlined, to indicate the advantages of those methods for under- 
standing the constitution. The physician must be familiar with 
the phenomena of health which include all the vital processes, 
become a close student of the manifold phases of human nature, 
discern natural tendencies as well as morbid proclivities, be con- 
versant with temperaments, constitutions and their peculiarities, 
be able to judge reasonably of the vital stamina, the activity of 
the recuperative powers, the individual ability to resist disease, 
and then weigh the probable consequences of functional depart- 
ures, and estimate the strength of the reacting energies which 
may be aroused by medicines. If he understands all these condi- 
tions, he may better decipher pathology, or diseased processes, 
and interpret and select remedies with a skillful discrimination, 
leading to success. 
242. No wonder that patients hesitate to employ a physician 
who is unacquainted with their temperament, aptitudes and pecu- 
liarities of constitution. We do not marvel at their dread of a 188 
COMMON SENSE MEDICAL ADVISER. 
strange doctor, who gropes in the dark, seeking for light by a 
series of medical experiments ! We are not at all amazed at 
receiving letters which disclose this anxiety, when the life is 
sometimes jeopardized, and the health staked on the judgment 
of those, who, in the absence of scientific considerations, begin a 
series of empirical tests and medicinal prescriptions, to end 
doubtfully, when they ought to be able to tell in advance, with 
surprising accuracy, precisely what that constitution will, and 
what it will not bear; to know what is essential to its recovery, 
and be able to prescribe the course of medicine which will prove 
successful. We say candidly and confidently, if physicians de- 
voted themselves as they ought, to the mastery of cerebral 
physiology, and to a more definite knowledge of the human tem- 
peraments, not only theoretically but practically, they could at 
a glance read the constitution, foretell to patients their peculiar 
liabilities and dangers, and thus give convincing evidence, that 
they are masters of their profession. 
243. We fully endorse Sir W. Hamilton, who writes : “ Analy- 
sis and synthesis, though commonly treated as two different 
methods, are, if properly understood, only the necessary parts of 
the same method. Each is the relative and correlative of the 
other.” We should thoroughly analyze the temperament, the 
cerebral powers and bodily functions, and then gather in one 
synthetical bundle, the symptoms which indicate aberration of 
functions, and all the signs of disease, to complete our knowl- 
edge of any given case. The vital and non-vital temperaments, 
each require a different plan of remedial operations in the 
same disease, because it will assume different phases in conse- 
quence of the variation in the arrangement of the organic 
elements. Hence, the great advantage possessed by the author 
of seeing a portrait of the patient, accompanying a full account 
of the symptoms. Although when they are correctly detailed, 
they may be a reliable guide, yet where there is doubt or ob- 
scurity, the portrait will indicate the temperament, the strength 
of the recuperative forces, the enfeebling tendencies, the vital 
powers, indeed, it shows us the organic history and constitutional 
condition of the patient, whose symptoms are described. Both 
indicate the extent of functional disorder or structural change. 
Thus we may scientifically combine analysis and synthesis to PKACTICAL IDEAS. 
189 
obtain a more perfect knowledge of a patients constitution, as 
well as diseased condition, and hence know better the appropri- 
ate remedies for his case, than we could otherwise learn by years 
of personal and experimental acquaintance. Individuals of the 
same temperament require dissimilar medicinal treatment. Sup- 
pose that the versatile actress, talented authoress, and accom- 
plished lady, Mrs. Anna Cora Mowatt Ritchie, had forwarded 
to us her portrait, represented by Fig. 96, and had accompanied 
the same with a delineation of symptoms which indicated nervous 
exhaustion, in consequence of 
unusually protracted mental 
effort; who does not instantly 
perceive that her treatment 
must be altogether different 
from that of an individual re- 
presented by Fig. 86. (We are 
not certain but that the latter 
may prosecute us for the bene- 
fits realized to mankind, by 
our references to his organiza- 
tion—while we almost fear in- 
numerable libel-suits arising on 
account of such unavoidably 
flattering comparisons)! The 
causes which produce debility 
in the former, cannot exist with 
the latter, even if we assume 
that it be an extreme representation of the sanguine tempera- 
ment. Contrast Mrs. Ritchie’s excellent nutritive system and her 
fair balance of elements with the encephalic endowments of Prof. 
Tholuck, Fig. 92. We at once infer that the latter would be 
more easily prostrated with depleting remedies, and that due 
caution should be exercised in administering cathartic medicine, 
even when such an evacuant is indicated. Great care should be 
employed when subjecting those organs to energetic treatment 
whose functions are enfeebling, when the sanguine elements are 
overbalanced by encephalic tendencies. Who does not recognize 
a full and harmonious development in the organization of Her- 
bert Spencer, as represented by Fig. 97. His is a remarkably 
Fig. 96. 190 
COMMON SENSE MEDICAL ADVISEE. 
active organization, indicating large mental and decided volitive 
characteristics, so blend- 
ed with sanguine ele- 
ments, that it is difficult 
to decide now, which 
are strictly natural and 
which are acquired. 
His exhaustive mental 
labors have measurably 
expended his sanguine 
forces, so that prudence 
admonishes him to be a 
• 
frugal economist, if he 
would enjoy the length 
of days that were origi- 
nally his by reason of 
vigor of constitution. 
The susceptibilities of 
his mind indicate the 
sensitiveness of every 
bodily organ, for nervous impressibility denotes functional sus- 
ceptiveness of all the structures. In administering medicine, 
this important consideration needs to be constantly borne in 
mind. Contrast, if you will, Fig. 98 — a representation of the 
lion. Daniel Webster, with that other gentleman, Fig. 99. True 
Fig. 97. 
Fig. 98. 
Fig. 99. 
the former possesses far more vitality and physical power, yet 
it is counter-balanced by remarkable intellectual and reasoning 
powers, calculated to expend and exhaust enormous vital supplies, PRACTICAL IDEAS. 
191 
whereas, to say the least, the “other gentleman” represented, is 
constitutionally more prudent. His intellectual expenditure will 
be, necessarily, very limited, and a sanguine development will 
make him sensual, if not almost bestial in his appetites. All 
these constitutional differences are reflected by diseases, and these 
elemental variations require corresponding remedial qualifica- 
tions. Contrast Fig. 80 with Fig. 89; their portraits and tem- 
peraments indicate that they are not naturally subject to the 
same class of diseases, and if both were infected with the same 
contagion, they would require treatment which must accord with 
their constitutional characteristics, which in importance equals 
that indicated by the abstract knowledge of the nature of the 
disease itself. 
244. A knowledge of cerebral physiology, of the vital and 
non-vital elements, and of all the powers of the constitution is 
essential to successful practice, in these days of indulgence and 
physical effeminacy. Since there are so many that avail them- 
selves of our skill, and send us their photographs, we would sug- 
gest that they obtain a quarter profile view, in a style as plain 
and natural as possible, and we would request the ladies not to 
encumber the hair with wads, or distort the shape of the head 
with braids. Our purpose is simply to analyze the temperament 
and constitution, and ascertain those tendencies which may assist 
us in adapting our remedies to the condition and various require- 
ments of our patients. Our readers can contrast the representa- 
tions which we have given to illustrate the different temperaments, 
and then ask themselves, is it possible that these differences in 
elements and structures involve no special consideration in the 
treatment of disease ? Because these branches of science have 
been hitherto considered as unimportant, is not that the reason 
why many carefully and critically educated physicians have met 
with frequent reverses in practice, while others, with inferior 
attainments, have achieved both fame and success ? Let us en- 
deavor to get at the truths indicated by nature, approach her 
reverently as earnest seekers and diligent students, ready to ac- 
cept her facts, interpret aright her realities and then apply her 
principles for the universal good. 
245. Having considered the question of marriage physio- 
logically, and indicated its temperamental advantages and 192 
COMMON SENSE MEDICAL ADVISEE. 
incompatibilities, we cannot refrain from a farther expression of 
our views upon certain other features which relate to health and 
human happiness; and while giving to our convictions a free and 
candid statement, our dissent with the views expressed by highly 
esteemed cotemporaries, is unavoidable. We cordially concede 
to them the purity of their motives, but think that upon this 
vital subject they are in error. CHAPTER XVI. 
M A It It IAGE. 
LOVE. 
“ Love is the root of creation; God’s essence; 
worlds without number 
Lie in his bosom like children; he made them 
for this purpose only. 
Only to love and to be loved again, he breathed 
forth his spirit 
Into the slumbering dust, and upright standing, it 
laid its 
Hand on its heart, and felt it was warm with a 
flame out of heaven.” 
Lonofellow. 
246. Love is the rudimental element of the human soul,—that 
delicate, inexplicable element which is the germinal essence of 
the human spirit. It is, therefore, a Divine gift — a blessing 
which the Creator did not withdraw from his erring children, 
when they were driven from a paradise of innocence and loveli- 
ness into a world of desolation and strife. He left it as an 
invisible cord by which to draw the human heart ever upward, 
to a brighter home — the heavenly Eden. Love is the very 
essence of Divine law, the source of inspiration, even the fountain 
of life itself. It is spontaneous, outflowing, infinite. To its 
presence we are indebted for all that is good, true and beautiful 
in Art and Nature. It endows humanity with countless virtues, 
and throws a mystic vail over our many faults. It is this love 
element — this immutable law, which controls the destiny of the 
race. Under its influence empires have fallen — sceptres have 194 
COMMON SENSE MEDICAL ADVISEE. 
been lost. Literature owes to Love its choicest gems. The poet’s 
lay is sweeter when Cupid tunes the lyre. The artist’s brush is 
truer if guided by Love. Greece was the cradle of letters and 
art. Her daughters were queens of beauty—fitted to inspire 
the Love of her noblest sons. 
247. The sensualism of the nineteenth century has sought to 
degrade Love,— to define it as purely physical. 
The result has been a corresponding degrada- 
tion of art and even literature has lost much 
of its lofty idealism. Nudity has become a 
synonym of vulgarity, Love, of lust. “Evil 
to him who evil thinks.” True Love never 
seeks to degrade its object; on the contrary, 
it magnifies every virtue, endows it with di- 
vinest attributes and guards its chastity, or 
honor at the sacrifice of its own life. It in- 
creases benevolence by opening the lover’s 
heart to the wants of suffering humanity. 
Ideality is the canvas and imagination the 
brush with which Love delineates the beauties 
of the adored. Love heightens spirituality, 
awakens hope, strengthens faith and enhances 
devotion. It quickens the perceptions, inten- 
sifies the sensibilities and redoubles the memory. 
It augments muscular activity and imparts 
grace to every movement. The desire to love 
and be loved is innate and forms as much a 
part of our being as bone or reason. In fact Love may be con- 
sidered as the very foundation of our spiritual existence, as bone 
and reason are the essential bases of our physical and intellectual 
being. Every man or woman, feels the influence of this love- 
element, sooner or later. It is the Kadesh-barnea of human 
existence ; obedience to its intuitions insures the richest bless- 
ings of life, while neglect or perversion enkindles His wrath, 
even as did the disobedience of the wandering Israelites. 
248. The one great fact which pervades the universe is ac- 
tion. The very existence of Love demands its activity, and 
hence the highest happiness is attained by a normal and legiti- 
mate development of this element of our being. The heart 
Fig. 100. CONJUGAL LOVE. 
195 
demands an object upon which to lavish the largess of its affec- 
tion. In the absence of all others, a star, a flower, or even a 
bird will receive this homage. The bird warbles a gay answer 
to the wTell-knovvn voice, the flower repays the careful cultivator 
by displaying its richest tints, the star twinkles a bright “ good 
evening ” to the lonely watcher and yet withal there is an un- 
satisfied longing in the lover’s heart, to which neither can respond 
— the desire to be loved! Hence the perfect peace of recipro- 
cated love. If its laws are violated, nature seeks revenge in 
the utter depression or prostration of the vital energies. Thus 
has the Divine Law-giver engraven His command on our very 
being. To love is therefore a duty, the fulfillment of which 
should engage our noblest powers. 
249. This emotion manifests itself in several phases promi- 
nent among which is filial affection — the natural harmonizer of 
society. Paternal love includes a new element, viz: protection. 
Greater than either and second only in fortitude to maternal 
affection, is 
CONJUGAL LOVE. 
“He is blest in Love alone 
Who loves for years and loves but one.”—Hunt. 
250. With Swedenborg we may assert, “that there is given 
love truly conjugal, which at this day is so rare, that it is not 
known what it is, and scarce that it is.” The same author has 
defined this relation to be a union of Love and Wisdom. The 
fundamental law of conjugal love is fidelity to one love. God 
created but one Eve, and the essential elements of paternal and 
maternal love pre-suppose and necessitate for their normal 
development — the Love of “ one ” only. Again, Love is the sun 
of woman’s existence. Only under its influence does she unfold 
the noblest powers of her being. Woman’s intuitions should 
therefore be taken as the true love-gauge If she desire a plural- 
ity of loves, it must be a law of her nature ; but is communism 
the desire of our wives and daughters? No ! Every act which 
renders woman dear to us, denounces such an idea and reveals the 
exclusive sacredness of her Love. As condemning promiscuity 
in this relation, we may cite the lovers’ pledges and oaths of 
fidelity, jealousy — the offspring of infidelity, the self-perpetuity 
of Love itself, the common sense instincts of mankind, as 196 
COMMON SENSE MEDICAL ADVISER. 
embodied in public sentiment, and the inherent consciousness that 
first love should be kept inviolable forever. Again, Love is 
conservative. It clings tenaciously to all the memories connected 
wTith its first object. The scenes consecrated to “ Love’s young 
dream” are sacred to every heart. The woodland with its wind- 
ing paths and arbors, the streamlet bordered with bending vio- 
lets and dreamy pimpernel, the clouds, and even “ the very tones 
in which we spoke ” are indelibly imprinted on the memory. 
There is also the “ mine and thine ” intuition of love. This 
sentiment is displayed in each thought and act of the lover. 
Every pleasure is insipid unless shared by the beloved; selfish 
and exacting to all others, yet always generous and forgiving 
to the adored. “Mine and thine, dearest,” is the language of 
Conjugal Love. 
251. The consummation desired by all who experience this 
affection, is the union of souls in a true marriage. Whatever 
of beauty or romance there may be in the lover’s dream, is en- 
hanced and spiritualized in the intimate communion of married 
life. The crown of wifehood and maternity is purer, more 
divine than that of the maiden. Passion is lost — the emotions 
predominate. 
252. The connubial relation is not an institution, it was born 
of the necessities and desires of our nature. “ It is not good for 
man to be alone,” was the Divine judgment, and so God created 
for him “ an helpmeet.” Again, “ male and female created He 
them,” therefore, sex is as divine as the soul. It is often per- 
verted, but so is reason, aye, so is devotion. 
2.53. The consummation of marriage involves the mightiest 
issues of life. It may be the source of infinite happiness or the 
seal of a living death. “ Love is blind ” is an old saying, verified 
by thousands of ill-assorted unions. Unhappy marriages* are 
traceable to one or more of three sources, viz: Incompatible 
temperaments, Physical inadaptation and Masquerading. The 
first has been alluded to in a former chapter (see temperaments, 
234-5-6). Every mental state has its physical accompaniment. 
Sexual intercourse is the natural expression of love, by which 
alone it is raised above the plane of mere animal indulgence. 
The normal and legitimate exercise of this function leads to 
enjoyment and reproduction. HISTOIIY OF MAKEIAGE. 
197 
254. Physical inadaptation renders the latter and oftentimes 
both, impossible. It may be a malformation from birth, but 
oftener it is an unnatural position or size of the generative organs. 
The absurd burdens which fashion imposes upon her victims, and 
the hidden vices which stain the private records of many, are 
fruitful sources of the miseries which in many instances are the 
dregs of the hymenial cup. 
255. Masquerading is a modern accomplishment. Girls wear 
tight shoes, burdensome skirts, corsets, etc., all of which prove 
so fatal to their health. At the age of seventeen or eighteen, 
our “young ladies” are sorry specimens of feminality; and pal- 
pitators, cosmetics and all the modern paraphernalia are required 
to make them appear fresh and blooming. Man is equally at 
fault. A devotee to all the absurd devices of fashion, he prac- 
tically asserts that “ dress makes the man.” But physical de- 
formities are of far less importance than moral imperfections. 
Frankness is indispensable in love. Each should know the other’s 
faults and virtues. Marriage will certainly disclose them — the 
idol falls — and the deceived lover is transformed into a cold, 
unloving husband or wife. By far the greater portion of un- 
happy marriages are attributable to this cause. In love especially, 
honesty is policy and truth will triumph. 
HISTORY OF MARRIAGE 
256. Polygamy and Monogamy. We propose to 
give only a brief dissertation on the principles and arguments of 
these systems, with special reference to their representatives of 
the nineteenth century. Polygamy has existed in all ages. It 
is and always has been the result of moral degradation or wan- 
tonness. The Garden of Eden was no harem. Primeval nature 
knew no community of love. There was only the union of two 
souls, “and the twain were made one flesh.” Time passed, “the 
sons of God saw the daughters of men that they were fair and 
they took them wives of all which they chose.” The propensi- 
ties of men were in the ascendant, and “ God repented Him that 
He had created man.” He directed Noah to take into the ark, 
“two of each sort, male and female.” But “the imagination of 
man’s heart is evil from his youth” and tradition points to 
Polygamy as the generally recognized form of marriage among 198 
COMMON SENSE MEDICAL ADArISER. 
the ancients. The father of the Hebrew nation was unquestion- 
ably a polygamist, and the general history of patriarchal life, 
shows that a plurality of wives and concubinage were national 
customs. In the earlier part of Egyptian history, Menes is said to 
have founded a system of marriage, ostensibly monogamous, but 
in reality it was polygamous, because it allowed concubinage. As 
civilization advanced, the latter became unpopular, and “ although 
lawful, was uncommon,” while polygamy was expressly forbid- 
ded. Solomon (according to polygamous principles) with his thou- 
sand women, should have enjoyed a most felicitous condition. 
Strange that he exclaimed “ A woman among all these have I 
not found.” According to the distinguised Rabbi, Maimonides, 
polygamy was a Jewish custom as late as the thirteenth century. 
When Cecrops, the Egyptian King, came to Athens (1550, B. C.) 
he introduced a new system which proved to be another step 
toward the recognition of Monogamy. Under this code a man 
was permitted to have but one wife and a concubine. Here 
dawned the era of Grecian civilization — an era, the glory of 
which was reflected in the social and political principles of West- 
ern Europe. During the fourth and fifth centuries, concubinage 
disappeared, but under the new regime the condition of the wife 
was degraded. She was regarded as simply an instrument of pro- 
creation and a mistress of the household, while a class of foreign 
women who devoted themselves to learning and the fine arts, 
were the admired, and ofttimes the beloved companions of the 
husbands. These were the courtesans who played the same role 
in Athenian history, as did the chaste matron, in the annals of 
Rome. When Greece became subject to Rome and the national 
characteristics of these nations were blended, marriage became a 
loose form of monogamy. In Persia, during the reign of Cyrus 
(560, B. C.), polygamy was sustained by custom, law and reli- 
gion. The Chinese marriage system was, and is, practically 
polygamous, for, from their earliest traditions, we learn that al- 
though a man could have but one Avife, he Avas permitted to 
have as many concubines as desired. 
257. In the Christian era, the first religious system which 
incorporated polygamy as a principle was Mohammedism. This 
system which is so admirably adapted to the voluptuous character 
of the Orientals, has penetrated Western Europe, Asia and HISTORY OF MARRIAGE. 
199 
Africa. Hayward estimated the number of its adherents to be 
one hundred and forty millions. The heaven of the Mohamme- 
dan is replete with all the luxuries which appeal to the animal 
propensities. Ravishing Houris attend the faithful who recline 
on downy couches in pavilions of pearl. On the Western Con- 
tinent a system of promiscuity was practised by the Mexicans, 
Peruvians, Brazilians and the barbarous tribes of North America. 
258. The Mormon Church was founded by Joseph Smith, and 
professes to be in harmony with the Bible and a special revela- 
tion to its leading Saint. According to the Mormonistic code, 
“ Love is a yearning for a higher state of existence, and the 
passions, properly understood, are feeders of the spiritual life ; ” 
and again, “ nature is dual; to complete his organization a man 
must marry.” The leading error of Mormonism is that it mis- 
takes a legal permission for a Divine command. The Mormon 
logic may be premised as follows: the Mosaic law allowed 
polygamy; the Bible records it; therefore, the Bible teaches 
polygamy. All will observe the fallacy at once. 
A Saint (man) can have no less than three wives hut as many 
more as he can conveniently or inconveniently support. The 
eight fundamental doctrines of the Mormon Church are stated 
as follows: 1. God is a person with the flesh and form of a man. 
2. Man is a part of the substance of God and will himself become 
a god. 3. Man is not created by God but existed from all eter- 
nity. 4. Man is not born in sin, and is not accountable for 
offenses other than his own. 5. The earth is a colony of embodied 
spirits, one of many such settlements in space. 6. God is presi- 
dent of the immortals, having under Him four orders of beings: 
(1.) Gods—i. e., immortal beings, possessed of a perfect organ- 
ization of soul and body, being the final state of men who 
have lived on earth in perfect obedience to the law. (2.) Angels, 
immortal beings who have lived on earth in imperfect obedience 
to the law. (3.) Men, immortal beings in whom a living soul is 
united with a human body. (4.) Spirits, immortal beings, still 
waiting to receive their tabernacle of flesh. 7. Man, being one 
of the race of gods became eligible, by means of marriage for a 
celestial throne, and his household of wives and children are his 
kingdom, not only on earth but in heaven. 8. The kingdom of 
God has been again founded on earth, and the time has now COMMON SENSE MEDICAL ADVISEE. 
come for the saints to take possession of their own; but by vir- 
tue, not by violence; by industry, not by force. This sect has 
met with stern and bitter opposition. It has been successively 
located in New York, Ohio, Missouri and Illinois, from the last 
of which it was expelled, by force of arms, and in 1848 estab- 
lished in Utah. Its adherents number, at the present time, more 
than one hundred thousand. 
259. Another organization, differing from the Mormons in 
many of its radical principles, are the “ Communists,” popularly 
termed “Free Lovers.” It is located at Lennox, Madison Co., 
N. Y. Its members advocate a system of “ complex marriage ” 
(so called), which is claimed to be instituted with a conscientious 
regard for the welfare of posterity. They disclaim “ promiscu- 
ity” and assert that the tie which binds them together is as 
permanent and sacred as that of Marriage! Community of 
property is commensurate with freedom of Love. They define 
love to be “ social appreciation,” and this element in their code 
of civilization (which they deem superior to all others) is second- 
ary to “ bodily support.” The principles upon which their social 
status is founded may be briefly summarized as follows: “Man 
oilers woman support and love (unconditional). Woman enjoy- 
ing freedom, self-respect, health, personal and mental compe- 
tency, gives herself to man in the boundless sincerity of an 
unselfish union. State—, Communism.” In this as in all forms 
of complex or polygamous marriages, love is made synonymous 
with sexuality, and its purely spiritual element is lost. In every 
instance this spiritual element should constitute the basis of mar- 
riage, which without it is nothing more than legal prostitution. 
Without it, the selfish degrading, animal propensities run ram- 
pant, while the emotions with all their boundless sweetness are 
dormant. Woman is regarded as only a plaything to gratify 
the animal caprice, and nausea and disgust inevitably follow. 
Their offspring (if they are so unfortunate as to have any) 
inherit all the basilar faculties, with but little of the counter- 
actives. 
260. That Monogamy is a law of nature is evident from the 
fact, that it fullfils the three essential conditions which form the 
basis of true marriage, viz: (1.) The development of the indi- 
vidual. (2.) The welfare of society. (3.) Reproduction. DEVELOPMENT OF THE INDIVIDUAL. 
201 
THE DEVELOPMENT OF THE INDIVIDUAL. 
261. (a.) Physically. Reciprocated love produces a general 
exhiliration of the system. The elasticity of the muscles is in- 
creased, the circulation is quickened, and every bodily function 
is stimulated to renewed activity. The duties of life, are per- 
formed with a zest and alacrity never before experienced. “ It 
is not possible for human beings to attain their full stature of 
humanity, except by loving long and perfectly. Behold that 
venerable man ! he is mature in judgment, perfect in every ac- 
tion and expression, and saintly in goodness. You almost wor- 
ship as you behold. What rendered him thus perfect ? What 
rounded off his natural asperities, and moulded up his virtues ? 
Love mainly. It permeated every pore, and seasoned every fibre 
of his being, as could nothing else. Mark that matronly woman. 
In the bosom of her family, she is more than a queen and god- 
dess combined. All her looks and actions express the outflowing 
of some or all of the human virtues. To know her is to love her. 
She became thus perfect, not in a day or year, but by a long 
series of appropriate means. Then by what ? Chiefly in and by 
love, which is specifically adapted thus to develop this maturity.” 
But all this occurs only when there is a normal exercise of sexu- 
ality. Excessive indulgence in marital pleasures deadens all the 
higher faculties, love included, and results in an utter prostration 
of the bodily powers. The Creator has endowed man and woman 
with passions, the suppression of which leads to pain, their grati- 
fication to pleasure — their satiety to disgust. In accordance 
with the eternal fitness of Ilis creations, if He had intended that 
polygamy should be the true system of marriage man would 
have been endowed with an excess of the passional element; but 
it is universally true that a perfectly healthy woman is fitted in 
every respect to gratify the natural desires and necessities of a 
man. Even excessive intercouse between a man and wife, pro- 
duces abnormal conditions of the generative organs and not 
unfrequently leads to incurable disease. Polyandry is as justifi- 
able as polygamy and neither is sustained by the laws of sexual 
physiology and hygiene. 
(b.) Morally and Intellectually. In no nation where the 
polygamous system prevails do we find a code of political and 202 
COMMON SENSE MEDICAL ADVISER. 
social ethics which recognizes the rights and claims of the 
individual. The condition of woman is that of the basest slave 
— a slave to the caprice and tyranny of her master. Communism 
raises her from the slough of slavery, but subjects her to the 
level of prostitution. An inevitable sequence of polygamy is a 
decline of literature and science. The people living in accordance 
with this or the communistic system, have never produced an 
intellectual genius. They have never added one original or 
fruitful idea to the general fund of learning. The natural ten- 
dency of each system is to sensualism. The blood is diverted 
from its normal channels and the result is, a condition which may 
be appropriately termed mental starvation. Sensualism is, in its 
very nature and sequences, directly opposed to literary attain- 
ments or advancement. Happily there is a “ golden mean,” an 
equalization of these elements which constitutes the acme of 
individual enjoyment. 
262. The general law of ethics, that “ whatever is beneficial 
to the individual, contributes to the highest good of society and 
vice versa,” applies with equal force to the hygienic conditions 
of marriage. Each family, like the Roman household, is the 
prototype of the natural government under which it lives. 
Wherever the marriage relation is regarded as sacred, there you 
will find men of pure hearts and noble lives, literally, soul-heroes. 
Of all foreign nations the Germans are celebrated for their sacred 
regard of woman, and the duties of marriage, and all scholars 
from the age of Tacitus to the present day, have concurred in 
attributing the elevation of woman to the pure-minded Teutons. 
In America law recognizes only Monogamy; but domestic un- 
happiness is a prominent feature of our national life; therefore, 
argues the would-be liberal and free-lover, monogamy does not 
accord with the best interests of mankind. The fallacy lies in 
the first premise. Legally, our marriage system is monogamous 
but socially and practically it is not! Prostitution is the source 
of this domestic infelicity. The “mistress ” sips the sweet nectar 
that is denied to the deceived wife. Legislators have battled 
with intemperance, but have done comparatively little to banish 
from our midst this necessary (?) evil. Shudderingly they turn 
THE WELFARE OF SOCIETY. WELFAIIE OF SOCIETY. 
203 
from this abyss of iniquity and disease. Within it is coiled a 
liydra-headed monster, that invades our hearth-stones, contami- 
nates our social atmosphere, and whose very breath is laden with 
poisonous vapors — the inexhaustible source of all evil. 
263. The tendency of the age is toward a system of lax mor- 
ality. The perverted appetites of mankind are mistaken for the 
natural desires and necessities of our being; and accordingly 
various arguments have been advanced to prove that monogamy 
is not salutary to social development. It is curious that no one 
of these arguments refers to the health and well-being of the 
individual, thus overlooking (perhaps willfully) the great law of 
social economy. Even a few medical writers (to whom the 
hygienic advantages of monogamy must be apparent) sometimes 
advocate the principles of this so-called liberalism. In a recently 
published work, there are enumerated only two demerits of 
polygamy and six, of monogamy. These six demerits which the 
author is pleased to term a “bombshell,” he introduces on ac- 
count of his moral convictions no less than humanitarian con- 
siderations. The same author terms monogamy a “ worm-eaten 
and rotten-rooted tree.” The worm that is devastating the 
fairest tree of Eden and draining its richest juices is what our 
cotemporary thinks, may be “plausibly termed, a necessary 
evil.” We may enumerate the arguments against monogamy as 
follows: (1.) Selfishness. It is claimed that monogamy begets 
narrow sympathies and leads to selfish idolatry. The fallacy of 
this argument is in the misapprehension of the term selfishness. 
Self-preservation is literally selfishness, yet who will deny that it 
is a paramount duty of man. If perverted it may be vicious, 
even criminal; but selfishness, in so far as it is generated by 
monogamy is one of the chief elements of social economy; fur- 
thermore it favors the observance of the laws of sexual hygiene. 
As we have said elswhere, true love increases benevolence and 
correspondingly expands and develops the sympathies. Selfish 
idolatry is far preferable to social neglect. The sequences of 
this argument will not bear a critical examination; for it is as- 
serted that in a happy union, “ love is so exclusive that there is 
hardly a liking for good neighbors, and scarcely any love at all 
for God.” If the “ good neighbors ” were equally blessed, they 
would not suffer from this exclusiveness, and it is practically true 204 
COMMON SENSE MEDICAL ADVISER. 
that there is no higher incentive to love and obey our Maker 
than the blessing of a happy marriage. (2.) Violation of Nature’s 
laws. It is asserted that “perfect physical and mental content 
and cheerfulness are not, nor can they be possessed by those who 
do not live naturally.” Reading farther, we find that to “ live 
naturally ” means to indulge the sexual appetite. This state- 
ment is erroneous. On the contrary, it is proved by facts, and 
acknowledged by all physicians that perfect chastity, insures 
longevity and a happy life. (3.) Again we read, “Monogamy 
overlooks the daily demonstrated fact that a married couply may 
grow apart.” The absurdity of this proposition is apparent. 
Admit it to be true and man is no higher than the brute, while 
on the other hand, it is a positive fact, that a living husband and 
wife are gradually assimilated and closely resemble each other in 
thoughts, feelings and actions. (4.) “Variation of stimulus is 
necessary to preserve the tone and health of every organ of sense, 
and prolonged application of the same stimulus exhausts it.” In 
a monogamous marriage, where the parties are temperamentally 
adapted, there is always a variation of stimulus, and we readily 
admit the fact that a prolonged application of any one stimulus 
is exhaustive; hence the fundamental law of sexual physiology, 
that excess in marital pleasures is not only unhealtliful, but will 
eventually engender disease, and result in death. 
THE PERPETUATION OF THE SPECIES. 
264. The third essential object of marriage is the perpetua- 
tion of the species. The desire for offspring is innate in the 
heart of every true man or woman. It is thus a law of our 
nature and as such must have its legitimate sphere. The essen- 
tial features of reproduction proclaim monogamy to be the true 
method of procreation. Promiscuity would render the mother 
incapable of designating the father of her children. In the lower 
animals, “ pairing ” is an instinctive law wherever the female is 
incapable of protecting and nourishing her offspring. During at 
least fifteen years, the child is dependent for food and clothing 
upon its parents, to say nothing of the requisite moral training and 
loving sympathy, which, in a great measure, mould its character. 
Fidelity to one promotes multiplication, according to the well 
known physiological law that a repeated planting of the seeds of PERPETUATION OF THE SPECIES. 
205 
life proves fatal. It has been argued by anti-monogamists that 
such a system interferes with woman’s god-given right to mater- 
nity. Of the many marriages celebrated yearly, comparatively 
few are sterile. The statement that many single women are 
desirous of having children, would apply only to a very limited 
number, as it is seldom that they are able to support children 
without the aid and assistance of a father. Promiscuity, dimin- 
ishes the number and vitiates the quality of the human products. 
“ Women of pleasure ” never give to the world sons of genius, 
or daughters of moral purity. CHAPTER XVII. 
REPRODUCTION. 
265. Every individual derives existence from a parent, 
which word literally means “ to produce.” Father signifies 
“generator.” We restrict the import of reproduction ordinarily, 
to that function by which living bodies produce other living 
bodies, similar to themselves. Production means, prolongation, 
continuance. Re-production, the producing again or renewing. 
To protract individual existence nutrition is necessary, because 
all vital changes are attended by wear and waste. Nutrition is 
always engaged in the work of reparation. Every organism that 
starts out upon its career of development, depends upon nourish- 
ing materials for growth, and upon this renewing process for 
mending and development. Having commenced, it must pass 
through regular succeeding stages of existence, until it reaches 
its . conclusion. Nutrition is all the while necessary to prolong 
the life of the individual, but at length its vigor wanes, its func- 
tions languish, and finally the light of earthly life goes out in 
darkness. Although the single organization decays and passes 
away, nevertheless the species is uninterruptedly continued; the 
tidal wave of life surges higher on the shores of time, for 
reproduction is as constant and stable as the attractive forces of 
the planetary system. 
266. It is a fact, that many varieties of the lower order of 
animals which once existed, are now extinct. It has been 
asserted and contradicted, that fossil remains of man have been 
found, indicating that the races which once existed, have dis- 
appeared from the face of the earth. The pyramids are 
unfolding a wonderful history, embracing a period of forty-five REPRODUCTION. 
207 
hundred years, which the world of science receives as literally 
authentic, and admits also, that fifty-four hundred years are 
probably as correctly accounted for. The extinction of races is 
not at all improbable. At the present time, the aboriginal in- 
habitants of this continent seem to be surely undergoing gradual 
extinguishment! It therefore seems to be a possible contin- 
gency for a weaker race to deteriorate, and continue to lapse, 
unless the causes of their decadence can be discovered and 
remedied. All people are admonished to look into and investi- 
gate the essential requirements of their continuance, for the rise 
and fall of nations is in obedience to natural principles and 
operations. Viewed from this stand-point, it is possible that 
a careful study of the human temperaments and their relations 
to reproduction, may be of greater moment than has hitherto 
been supposed, and their proper understanding may tend to 
avert that individual deterioration, which, if suffered to become 
general, would end in national disaster and race extinction. 
267. Observation.—Until recently, naturalists even, believed 
that descendants were strictly like their parents, in form and 
structure. Now it is known that the progeny may differ in both 
form and structure from the parent, and that these may produce 
others, still more unlike their ancestry. But all of these 
peculiar and incidental deviations finally return to the original 
form, showing that these changes have definite limits, and that 
the alternations observe a specific variableness, which is finally 
completed by its assuming again the original form. (See 24, 
Figs. 2 and 3). 
268. Reproduction may be Sexual or Ron-Sexual. In 
some plants and animals, it is non-sexual. The propagation of 
species is accomplished by buds. Thus the gardener engrafts a 
new variety of fruit upon an old stock. The florist understands 
how to produce new varieties of flowers, and make them 
radiantly beautiful in their bright and glowing colors. The bud 
personates the species, is a perfect individuality and produces 
after its kind. Some of the annelides, a division of articulate 
animals, characterized by an elongated body, formed of numer- 
ous rings or annular segments, multiply by spontaneous division. 
A new head is formed at intervals in certain segments of the 
body. (See Fig. 101). 208 
COMMON SENSE MEDICAL ADVISER. 
Something similar to this process of budding, we find taking 
place in a low order of animal organization. Divide the Fresh- 
water Polyp into several pieces, and each one will grow into an 
entire animal. Each piece represents a polyp, and so each 
parent polyp is really a compound animal, an organized commu- 
nity of beings. Just as the buds of a tree are separated and 
grow again when engrafted upon another tree, each preserving 
its original identity, so do these animals, when divided, each sepa- 
rated part becoming an individual polyp, capable of similar 
reproduction. 
Fig. 101. 
An annelid dividing spontaneously, a new head having been formed toward the 
hinder part of the body of the parent. 
269. The Revolving Yolvox likewise increases by growth 
until it becomes a society of animals, i. e., a multiple system of 
individuals. There are apertures from the parent, by which 
water gains a free access to the interior of the whole miniature 
series. This monad was once supposed to be a single animal, 
but the microscope shows it to be a group of animals in organic 
connexion by means of six processes, and each little growing 
Volvox exhibits his red-eye spec and two long spines, or horns. 
These animals also multiply by dividing, and thus liberate a 
smaller series, which, in their turn, spontaneously reproduce 
other groups. 
270. Generation requires the concurrence of Stimuli and 
Susceptibility, and to perfect the process, two conditions are also 
necessary. The first is the Sperm, which communicates the 
principle of action, the latter is the Germ which receives the 
latent life and provides the arrangements adapted to organic 
evolution. The vivifying function belongs to the male, the 
nourishing and cherishing is possessed by the female, and these HERMAPHRODITIC OR DICECIOtTS. 
209 
conditions are sexual distinctions. The former represents Will 
and Understanding, the latter, Vitality and Emotion. The 
father directs and controls, the mother fosters and encourages; 
the former counsels and admonishes, the latter persuades and 
caresses; and their union in holy matrimony represents one, that 
is, the blending of vitality and energy, of love and wisdom, the 
elements indispensable to the initiation of life under the dual 
conditions of male and female, one in the functions of 
reproduction. 
271. Let us consider the Plans of Sexual Reproduction, 
which are either 
HERMAPHRODITIC OR DIOECIOUS. 
We have said that two set of cells represent reproduction, 
viz: Sperm and Germ-cells. These may be furnished by differ- 
ent individuals, or the two set may be found in one. When 
found in the same individual, the parent is said to be a ISTatukal 
hermaphrodite, that is, a perfect hermaphrodite possesses the 
attributes of both male and female—unites both sexes in one 
individual. Natural hermaphroditic reproduction occurs among 
inferior classes of animals, and naturalists inform us that there 
is a much greater number of these than of the more perfect 
varieties. True, these are found low in the scale of animal 
organization, and are able to propagate without the concourse 
of the sexes. The Oyster, Lamp-cockle and Ascidia are exam- 
ples of animals, in which no organs can be detected in the male, 
but in the female they are developed. Polyps, Sponges and 
Cystic Entozoa may also be included in these examples. 
Observation.—It is only very low organisms indeed in which 
it is a matter of indifference whether the united sperm-cells 
and germ-cells are those of the same individual, or those of 
different individuals. In more elaborate structures and highly 
organized beings, the essential thing in fertilization, is, the union 
of these cells specially endowed by different bodies, the unlike- 
ness of derivation in these united reproductive centres being the 
desideratum to life and power. 
In other classes, as Entozoa, there appear to he special pro- 
visions whereby the sperm-cells and germ-cells may be united, 
i. e., the male organs are developed, and so disposed as to fecun- 
date the ova of the same individual. Sexual and non-sexual 210 
COMMON SENSE MEDICAL ADVISER. 
inodes of reproduction are illustrated by that well defined group 
of Marine Invertebrate Animals called Cirripedia. (See Fig. 
102, representing one of the genus). 
Some of these are not only capable of 
self-impregnation, but likewise have what 
are called, complemented males attached to 
some of the hermaphrodites. In the whole 
animal kingdom, it may be doubted if there 
exists another so rudimentary a creature as 
these parasitic males, who possess neither 
mouth, stomach, thorax nor abdomen, and 
after exerting a peculiar sexual influence, 
soon die and drop off; so that in this class 
of animals may be found the sexual dis- 
tinctions of male, female and perfect hermaphrodites. 
272. There is a class of Wheel-Animalcules under the name 
of Rotatoria (of which the Revolving Volvox is one example). 
They have acquired this name probably on account of the ap- 
parent rotation of the disc-like organs which surround their 
mouths and which are covered with “cilia” (little hairs). They 
are minute creatures, and can best be 
viewed with a microscope, although 
larger forms may be seen without 
such assistance. They are widely 
diffused on the surface of the earth, 
inhabit lakes as well as the ocean 
and are found in cold, temperate 
and tropical climates. The Roti- 
fera were once supposed to be her- 
maphrodites, but the existence of 
sexes in one species has been clearly 
established. The male, however, is 
much smaller and far less developed 
than the female. In some of these 
species, germ-cells or eggs are found, 
which do not require fecundation 
for reproduction or development, so 
that they belong to the non-sexual 
class of reproducers. 
Fig. 102. 
Pollicipes Mitella. 
Fig. 103. 
Rotifera; Brachionus Urceolaris; 
largely magnified. HERMAPHRODITIC OR DKECIOL'S. 
211 
The third variety of hermaphrodites embraces those animals 
in which the male organs are so disposed as not to fecundate 
the ova of the same body, but require the concourse of two 
individuals, notwithstanding the co-existence in each of the 
organs of both sexes. Each in turn, impregnates the other. 
The common leech, earth-worm and snail propagate in this 
manner. 
273. Unnatural hermaphrodism is characteristic of insects 
and crustaceans, where the whole body indicates a neutral char- 
acter, tending to exhibit the peculiarities of male or female, in 
proportion as the kind of sexual organs predominate. Half of 
the body may he occupied by male, the other half by female 
organs, and each half reflects its sexual characteristics. Some 
of the Papilio (and the genus includes that beautiful class of 
insects known as butterflies,) may be dimidiate hermaphrodites, 
i. e., present on one side the form and color of the male, on 
the other, that of the female. The wings show by their color and 
appearance these sexual distinctions. The stag-beetle also is an 
example. We have accounts of dimidiate hermaphrodite lob- 
sters, male in one half and female in the other half of the body. 
Observation.—Among the numerous classes of higher animals, 
which circulate red blood, we have heard of no well authenticated 
instance of hermaphrodism, or the complete union of all the 
reproductive organs in one individual. True the term her- 
maphrodite is often applied to certain persons in whom there is 
some imperfection, deficiency or excess of the genital organs. 
The very fact that such are thereby incapacitated for generation 
shows that it is a malformation, whereas, true hermaphrodism is 
a mode of reproduction. Hence these congenital deformities, 
consisting in combined increase or deficiency, supernumerary or- 
gans or transposition of them, which render generation physically 
impossible, have been called bisexual hermaphrodism, and classed 
as monstrosities. We have many published accounts of them. 
In Paris, France, there was a widower, who had, in addition to 
male organs, a uterus and ovaries, but the external female “ gen- 
italia” were wanting. Samuel Torry, M. D., U. S. A., records 
an instance of a colored man, who, in addition to male organs, 
had a short vaginal passage, from which exuded the “ menstrua,” 
regularly every month. The causes which tend to produce in 212 
COMMON SENSE MEDICAL ADVISEE. 
the same individual, organs which represent in part both sexes, 
are rather obscure. 
274. Certain theories have been advanced concerning condi- 
tions that may influence the sex of the offspring. One is that 
the right ovary furnishes the germs for males, the left for 
females; that the right testicle furnishes sperm capable of fructi- 
fying the germs for males, and the left testicle, the germs of the 
left ovary, for females. That fecundation sometimes takes place 
from right to left and thus produces these abnormal variations. 
We merely state the hypothesis, but do not regard it as account- 
ing for the distinctions of sex or of the cause of monstrosity, 
though it is somewhat plausible as a theory, and is not easily 
disproved. In the lower order of animals, as sheep and swine, 
one of the testicles has been removed, and there resulted after- 
ward both male and female progeny, so that the theory seems 
to lack facts for foundation. 
We sometimes witness in the child, excessive development, as 
five fingers, or too large cranium followed by dropsical effusion, 
or deficient brain, as in idiots; sometimes a hand or arm is lack- 
ing, or possibly there is a dual connection, as in the case of the 
Siamese twins; or two heads united to one body. It will be 
difficult to give any satisfactory explanation of these abnormal 
developments. The marvel is that they occur so seldom. From 
age to age the genetic force is constant, indivisible and preserves 
a race-unity. The crossings of the races are only transient de- 
viations, not capable of perpetuation, and quickly return again 
to the original stock. This force is loyal, for inasmuch as the 
individual represents the race, so does his offspring represent the 
parental characteristics, in tastes, proclivities and morals, as well 
as in organic resemblances. This constancy is unaccountable, 
more mysterious than occasional arrest, excess, malformation or 
improper development of germs, in the early period of foetal 
life. If to every deviation from that original form and struc- 
ture, which gives character to the productions of nature we 
apply the term monster, we shall find but very few, and from 
this whole class, there will be a very small number indeed, of 
sexual malformations. If either sex are deprived of the genera- 
tive organs, they approach each other in disposition and appear- 
ance. All those who are partly male and partly female in their DICECIOUS REPRODUCTION. 
213 
oi'ganization, unite, to a certain extent, the characteristics of 
both sexes. When the female loses her prolific powers, many 
of her sexual peculiarities and attractions wrane also. 
DICECIOITS REPRODUCTION. 
275. Dioecious is a word derived from the Greek, and signi- 
fies “two households,” i. e., dioecious reproduction is sexual gen- 
eration by male and female individuals. Each is distinguished 
by sexual characteristics. The male sexual oi’gans are complete 
in one individual, and all the female organs belong to a separate 
feminine organization. With some of the vertebrates, impreg- 
nation does not require sexual congress; in other words, fecun- 
dation may take place externally. The female fish of some 
species, first deposits her ova, and afterwards, the male swims 
to that locality and fei’tilizes them with sperm. 
276. In higher orders of animals, fecundation occurs inter- 
nally, the conjunction of the sperm and gercn-cells requiring the 
conjugation of the male and female sexual organs. The sperm- 
cells of the male furnish the quickening principle, which sets in 
play all the formative energies, while the germ-cell, susceptible 
to its vivifying presence, responds with all the conditions neces- 
sary to evolution. The special laboratory which furnishes spei-- 
matic material is the testes, while the stx*oma of the ovaries, 
contributes the germ-cell. Several different modes of reprodu- 
cing are observed when fecundation occurs within the body, 
which vary accoi'ding to the peculiarities and organization of 
the female. 
277. Modes of Dioecious Reproduction. Avery 
familiar illustration of one mode, is found in the common do- 
mestic fowl, whose egg, vivified within the ovarium, is afterward 
expelled and hatched by the simple agency of warmth. The 
“ tread ” of the male is necessary but once during a season, to 
quicken the entix-e series of eggs in process of development. 
This mode of reproduction is called Oviparous generation. 
Observation.—The ovaries as well as all their latent germs are 
remarkably influenced by the first fecundation. It seems to 
indicate monogamy as the rule of higher sexual reproduction. 
The farmer understands that if he wishes to materially improve 
his kine, the first offspring must be begotten by a better, purer 214 
COMMON SENSE MEDICAL ADVISEE. 
breed, and all that follow will be essentially benefitted, even if 
not as well sired. Neither will the best blood exhibit its most 
desirable qualities, in the calves whose mothers have previously 
carried inferior stock. So that there are sexual ante-natal influ- 
ences, which may deteriorate the quality of the progeny. The 
Jews understood this principle, in the raising up of sons and 
daughters unto a deceased brother. The fact that the sexual in- 
fluence of a previous conception is not lost, is illustrated when in 
a second marriage, the wife bears a son or daughter resembling 
bodily or mentally, or in both of these respects, the former hus- 
band. This indicates union for life by natural influences which 
never die out. 
278. With some species of fish and reptiles, the egg is im- 
pregnated internally, and the process of laying commences 
immediately, but it proceeds so slowly through the excretory 
passages, that it is hatched, and born alive. This is called 
©vi-viviparous generation. 
279. As we rise in the scale of organization, animals are more 
completely developed, and greater economy is displayed in their 
preservation. The germ passes from the ovarium into an organ 
prepared for its reception and growth, to which, after fecundation, 
it becomes attached, and where it remains until sufficiently devel- 
oped to maintain respiratory life. This organ is called “ the 
'WombC or Uterus, and is peculiar to most mammalia. This 
mode of reproduction is termed Viviparous generation. 
280. The Kangaroo and Opossum are provided with a pouch 
on the abdomen which receives the young, born at an early stage 
of development. They remain in contact with the mammae, from 
which they obtain their nourishment until their growth is suffi- 
ciently completed to maintain independent existence. This is 
called jflarsiipial generation. The variety of reproduction 
which is most interesting, is that which concerns the human 
species, and is called viviparous generation. It includes the 
functions of Copulation, Fecundation, Gestation, Parturition 
and Lactation. 
281. For the full and perfect development of mankind, both 
mental and physical chastity is necessary. The health demands 
abstinence from unlawful intercourse. Therefore children should 
be instructed to avoid all impure works of fiction, which tend to COMPARISON OF MALE AND FEMALE 
215 
Fig. 104. 
Fig. 105. 
Male. 
Female. 216 
COMMON SENSE MEDICAL ADVISER. 
inflame the mind and excite the passions. Only in total abstinence 
from illicit pleasures is there safety, morals and health, while in- 
tegrity, peace and happiness are the conscious rewards of virtue. 
Impurity travels downward with intemperance, obscenity and 
corrupting diseases, to degradation and death. A dissolute, 
licentious, free-and-easy life is filled with the dregs of human 
suffering, iniquity and despair. The penalties which follow a 
violation of the law of chastity, are found to be severe and 
swiftly retributive. 
282. The union of the sexes in Holy Matrimony is a law of 
nature, finding sanction in both morals and legislation. Even 
some of the lower animals unite in this union for life and in- 
stinctively observe the law of conjugal fidelity with a consistency 
which might put to blush other animals, more highly endowed. 
It seems important to discuss this subject and understand our 
social evils, as well as the intense passional desires of the sexes, 
which must be controlled, or lead to ruin. 
283. Sexual propensities are possessed by all, and these must 
be held in abeyance, until they are needed for legitimate pur- 
poses. Hence pai’ents ought to understand the value to their 
children, of mental and physical labor to elevate and strengthen 
the intellectual and moral facilities, to develop the muscular sys- 
tem and direct the energies of the blood into healthful channels. 
Vigorous employment of mind and body engrosses the vital en- 
ergies and diverts them from undue excitement of the sexual 
desires. 
284. Sexual generation by pairing individuals, is the most 
economical mode of propagating the species. The lower orders 
of animals possess wonderful multiplicative powers, and their 
faculty for reproduction is offset by various destructive forces. 
The increased ability for self-maintenance implies diminished re- 
productive energy, hence the necessity for greater economy and 
safety in rearing the young. As certain larvae and insects in- 
crease, the birds that feed upon them become more numerous. 
These same birds again disappear, accordingly as their food be- 
comes scarce. Many have remarked, that very prolific seasons 
are followed by unusual mortality, just as periods of uncommon 
prosperity precede those of singular disaster. 
‘285. The increased mental and moral cultivation of mankind DICECIOUS REPRODUCTION. 
219 
imposes upon them the necessity for greater physical culture. 
“ Wiser and weaker,” is a trite saying, and means, that the exer- 
cise of the higher nature discloses the equivalent necessity of 
culturing the body, in order to support the increasing expendi- 
tures of the former. Mental and moral discipline are essential 
to a proper understanding of how to provide for the body, for 
physical training increases the capacity of the individual for 
self-preservation. Vigilance is the price of health as well as of 
liberty. 
286. It was a quaint remark of Van Helmont that “the 
uterus alone makes a woman what she is.” Without doubt the 
ovaries exert a specific influence, no less characteristic than that 
of the “ testes ” of the male. From infancy to puberty, the sex 
as well as the body, structurally and functionally, is in a state of 
gradual and progressive evolution. Men and women generally 
increase in stature until the twenty-fifth year, and it is safe to 
assume, that perfection of function is not established until 
maturity of bodily development is completed. (See Figs. 104 
and 105). The physical contour of these representations plainly 
exhibits the difference in structure, and also implies difference of 
function. Solidity and strength are represented by the organi- 
zation of the male, grace and beauty by that of the female. 
His broad shoulders represent physical power and the right of 
dominion, while her bosom is the symbol of love and nu rition. 
The father will encounter hardships, struggle against difficulties 
and brave dangers to provide for his household; the mother 
tenderly supplies the infant’s wants, finding relief and pleasure 
in imparting nourishment, and surrounds helpless infancy with 
an affection which is unwearied with its thousand ministering 
attentions. Thus man and woman complement each other’s 
being. Her maternal functions are indicated by greater 
breadth of the hips. Physical differences so influence their 
mental natures, that, “ before experience has opened their eyes, 
the dreams of a young man and maiden differ.” The develop- 
ment of either is in close sympathy with their organs of 
reproduction. Any defect of the latter, impairs our fair ideal, 
and detracts from those qualities which impart excellence and 
crown the character with perfections. Plainly has Nature 
marked out, in the organization, very different offices to be 220 
COMMON SENSE MEDICAL ADVISER. 
performed by the sexes, and made these distinctions fundamental. 
(See Figs. 106 and 107). 
287. Likewise, Nature expresses the intention of reproduc- 
tion, by giving to plants and animals distinctive organs for this 
purpose. These are endowed with exquisite sensibility, so that 
their proper exercise is consistent with excitement and great en- 
joyment, beneficial to both. Excessive indulgence, however, in 
sexual gratification, not only prostrates the nervous system, en- 
feebles the body and drains the blood of its quickening elements, 
but it is inconsistent with intellectual activity, moral soundness, 
or spiritual development. The most entrancing delights, and 
consummate enjoyments are of the emotive order, ideal, abstract 
and pure, so spirit-inspiring and joy-transporting, that they an- 
tagonize the grosser sensual pleasures and shed their own sweet 
chastity and refining elegance over all the processes of life. 
288. Hence the gratification of the sexual instincts, when law- 
ful, should always he moderate. With the male, previous to the 
very instant of emitting the seminal fluid, the act is voluntary, 
and the emission can be stopped. But if allowed to continue, 
the glans becomes the seat of a completely new and specific sen- 
sibility, which is attended by an involuntary contraction of the 
ejaculatory muscles that discharge the semen. It is only the final 
orgasm that is uncontrollable. Therefore sexual intercourse 
can be regulated and restricted by the judgment and will, and 
kept within the bounds of health. No person has a moral right 
to carry this indulgence so far as to produce injurious conse- 
quences to either party, and he who cannot refrain from furious 
sexual excitement, is in no proper condition to propagate his 
species. As an act of physical and spiritual communion, it 
should always be regulated by prudential considerations, and 
when exercised with a view to procreation, it should be em- 
ployed when all the faculties not only consent, but desire 
offspring. In all culture, there must be self-control, and the 
practice of self-denial at the bidding of love and right, is always 
esteemed a virtue. It is a manly trait, and ranks with such 
dignities as Integrity, Uprightness, Probity and Rectitude, all 
expressive of the moral excellence that comes from self-discipline. 
Self-government is the polity of our people, and we point with 
pride and laudable exultation to our political maxims, laws and MENSTRUATION. 
221 
free institutions. The principles of the family, type that of 
society. If self-restraint is practiced in the family relation, 
then the principle of self-control will carry health, strength and 
morality into all parts of the common-wealth. The leading 
characteristics of any nation are but the reflection of the traits 
of its individual members, and thus the family, truly typifies 
the practical morality and enduring character of a people. 
OVULATION. 
289. The Ovaries are those essential parts of the generative 
system of the human female, in which ova are matured. There 
are two Ovaries, one on either side of the uterus, and connected 
with it by the Fallopian tubes; they are ovoid bodies about an 
inch in diameter, and furnish the germs or ovules. These latter 
are very minute, seldom measuring 1-120th of an inch in diame- 
ter, and frequently they are not more than half that size. The 
ovaries develop with the growth of the female, so that 
finally at the pubescent period they ripen and liberate an ovum 
or germ vesicle, which is carried into the uterine cavity by the 
Fallopian tubes. By the aid of the microscope, we find that these 
ova are composed of granular substance, in which is found a 
miniature yolk surrounded by a transparent membrane, called 
the zona pellucida. This yolk contains a germinal vesicle, in 
which can be discovered a nucleus, called the germinal spot. The 
process of the growth of the ovaries is very gradual, and their 
function of ripening and discharging one ovum monthly into 
the Fallopian tubes and uterus, is not completed until between 
the twelfth and fifteenth years. 
290. This period, which indicates, by the feelings and ideas, 
the desires and will, that they are capable of procreation, is 
called Puberty. The mind acquires new and more delicate pei’- 
ceptions, the person becomes plumpei*, the mammae enlarge, and 
there is grace and perfection in every movement, a conscious 
completeness for those relations of life to which this function 
prepares them. The period of puberty is also indicated by 
MENSTRUATION. 
291. The catamenial discharge naturally follows the ripening 
and liberation of an ovum, and as the ovaries furnish one of these 222 
COMMON SENSE MEDICAL ADVISEE. 
each month, this monthly flow is termed the menses, the plural 
of mensis, a month. The menstrual flow continues from three 
to five days, and is merely the exudation of ordinary venous 
blood through the mucous surface of the cavity of the uterus. 
At this time, the nervous system of females is much more sensi- 
tive, and from the fact that there is greater aptitude to conception 
immediately before and after this period, it is supposed that the 
sexual feeling is then the strongest. When impregnation occurs 
immediately before the appearance of the menses, their dura- 
tion is generally shortened, though not sufficiently to establish 
the suspicion that conception has taken place. The germ 
is the contribution of the female, which provides the condi- 
tions that need the vivifying principle of life for the devel- 
opment of another being. The period of aptitude to conception 
terminates when both ovulation and the menses cease, which, 
unless brought about, earlier by disease, usually occurs about 
the fortyfifth year of age. 
FECUNDATION. 
292. Whereas, in the beginning, God created male and 
female, and said unto them, “Be fruitful, and multiply and 
replenish the earth,” it indicates that what was originated by 
creation must be continued by procreation. The process of 
generation, the reader will find described in 18-19. Then 
commences a wonderful series of transforming operations, rudi- 
mentary changes preliminary to the formation of tissues, 
structures and functions which finally qualify the organization 
for independent existence. Immediately upon the conjugation 
of two infinitesimally small particles of matter, called the sperm 
and germ-cells, or their mere “ touching ” each other, the germ 
acquires a new disposition to adhere to any organ or part with 
which it happens to come in contact. It instinctively endeavors 
to establish an advantageous connection, in order to draw sup- 
plies of nutrient material for purposes of development. Such 
a union, wherever it may take place, is technically termed 
Conception. The condition which follows it, is called Pregnancy. 
The impregnated ovum is liable to form a connection with any 
organ where it is permitted to remain. Fecundation may occur 
at the Ovaries, within the Fallopian Tubes or in the cavity of FECUNDATION. 
223 
the Uterus. The latter organ is specially designed to receive 
and nourish the fecundated germ, and when it fixes itself upon 
its internal surface, it is called Uterine Pregnancy. This con- 
ception is natural and favorable for both the mother and embryo. 
When it adheres to other organs it is an unnatural conception, 
and not safe for either. 
293. If the fecundated germ adheres to the ovary, it is termed 
Ovarian Pregnancy. If it attaches to the fallopian tubes, it is 
called Tubal Pregnancy. If in consequence of a mis-step, blow 
or fall, it is precipitated into the abdominal cavity, it will unite 
to the parts with which it comes in contact, and is then desig- 
nated as Ventral Pregnancy. If the microscopic germ lodges 
in some slight interstice of fibres, during its passage through the 
walls of the uterus, it may be detained long enough to fix itself 
there, and when it does so, it is termed Interstitial Pregnancy. 
All of these misconceptions may necessitate the employment of 
surgical skill, in order that they may terminate with safety to 
the mother. Their occurrence, however, is very rare. 
294. One result of the sexual embrace is Insemination, by 
which term we understand that the sperm is left within the 
genital passages, generally at the superior portion of the vagina, 
near the mouth of the uterus. The duration of the interval be- 
tween insemination and fecundation may be longer or shorter, 
depending upon circumstances. If the sperm-cell travels to the 
ovarium, it takes generally from three to five days to make the 
journey. Its transportation is aided by the ciliary processes 
(little hairs) of the mucous surface of the vaginal and uterine 
walls, as well as by its own vibratile movements. The action of 
the cilia, under the stimulus of the sperm, seems to be from with- 
out, inward. Even if a minute particle of sperm, less than a 
drop, be left upon the margin of the external genitals of the 
female, it is sufficient in amount to impregnate, and can be car- 
ried, by the help of these cilia, to the ovaries. The liability to 
fecundation is not only great, but imminent. Where all the 
organs are healthful, the capacity, tendency — aptitude is almost 
irrepressible. This proclivity is so constant and unfailing, that 
it is almost absolutely uncontrollable. It is so natural and potent 
a disposition, that any amount of prudence and the most careful 
precautions, sometimes entirely fail to prevent pregnancy. 224 
COMMON SENSE MEDICAL ADVISEE. 
PREVENTION OF CONCEPTION. 
295. Much has been written upon this subject, and upon the 
right that matrimonial parties have to decline the responsibilities 
of wedlock. The practice of inducing abortion is not only im- 
moral but criminal, because it is destructive to both health and 
life. If the parties to a marriage are both feeble, or if they are 
temperamentally unadapted to each other so that their children 
are deformed, insane or idiots, then to beget offspring would be 
a flagrant wrong. If the mother is already delicate, possessing 
feeble constitutional powers, she is inadequate to the duties of 
maternity, and it is not right to lay such burdens upon her. 
Self-preservation is the first law of nature, which all ought to 
respect. The woman may be able to discharge the duties of a 
loving wife and companion, when she cannot fulfill those of child- 
bearing. If the husband loves his wife as he ought, he will 
forego all the pleasure necessary to secure her exemption from 
the conditions of maternity; it seems to us, that it is a great 
wickedness, unpardonable even, to be so reckless of consequen- 
ces, and so devoid of all feeling, as to expose a frail, feeble 
affectionate woman to those perils which almost insure her death. 
To enforce pregnancy under such circumstances is a horrible 
crime. Every true man will rather enforce continent forbear- 
ance, at all events acquire sufficient to control all 
untoward events. 
296. Often impregnation results without its occurrence having 
been intended, and when the possibility of its contingency was 
supposed to have been guarded against. The warmth of the 
nuptial instincts indicates the aptitude to, and imminent peril of 
maternity. Before the mother has recovered from the effects of 
bearing, nursing and rearing one child, ere she has regained 
proper tone and vigor of body and mind, she is unexpectedly 
overtaken, surprised by the manifestation of symptoms which 
again indicate pregnancy. Children thus begotten cannot be- 
come hardy and long-lived. By the love that parents may feel 
for their posterity, by the wishes for their success, by the hopes 
for their usefulness, by every consideration for their future well- 
being, let them exercise precaution and forbearance until the 
wifo becomes sufficiently healthy and enduring to bequeath her 
own rugged, vital stamina to the child she bears in love. PREVENTION OP CONCEPTION. 
225 
297. We do not feel at liberty to discuss the means, most 
consistent with health and nature, which may tend to remedy 
these evils. The absolute prevention of conception is inconsis- 
tent with the full enjoyment of marital pleasures, and w*e do not 
wish to make any suggestions, a knowledge of which might lead 
bad men or women into the propagation of wrong. All good 
may be perverted and become the cause of evil, therefore, while 
acting with pure intents, we think it is better to refrain from 
giving any counsels or directions which may be turned to im- 
proper account. Beyond the imparting of instruction, and 
advice and admonition concerning the dangers which surround 
this subject, we do not feel it our duty, personally, to assume 
any responsibility whatever. Our sympathies, always suscepti- 
ble to the conditions of sorrow and suffering, have been enlisted 
to give faithfully, explicitly and plainly, warnings of danger and 
exhortations to prudence, and nothing remains to us but to main- 
tain the principles of morality, and leave to the disposal of a 
wise and overruling Providence the mystery of all seemingly 
untoward events. In every condition of life evils arise, and 
most that are encountered are avoidable. Humanity is held 
accountable for those which it might, but does not shun. 
298. This anomaly in law and morals exists,—that by a stat- 
ute of the general government, prevention of pregnancy is 
considered an offense to be visited by penalties, whereas every 
physician is instructed by our standard writers and approved 
lecturers on this subject, that not only prevention is necessary 
in many instances, but that abortion must sometimes be produced 
in order to save the mother’s life. As we view the matter, the 
law of the general government asserts the ruling principle, and 
the exceptions to it must be well established. by evidence, in 
order to fully justify such procedure. The only safety is in 
moral consistency of life, and even when governed by the highest 
dictates of right, mankind encounters trials and difficulties suffi- 
cient to test the strength of steady nerves and the tenacity of 
upright pui’poses. 
299. After fecundation, the length of time is variously esti- 
mated, before conception takes place. Should impregnation 
occur at the ovary or within the fallopian tubes, usually about 
a week elapses before the return of the fertilized germ to the 226 
COMMON SENSE MEDICAL ADVISER. 
uterus, so that ordinarily the interval between the act of insemi- 
nation and that of conception varies from eight to fourteen 
days. 
DOUBLE CONCEPTION. 
300. If two germs be evolved simultaneously each may be 
impregnated by spermatozoa, and a twin pregnancy be the result. 
This is by no means a rare occurrence. It is very unusual, how- 
ever, to have one birth followed by another, after an interval of 
three or four months, and each babe present the evidence of full 
maturity. Perhaps such occurrences may be accounted for as 
follows: Allow the same interval of time between the impreg- 
nation of the two germs as there is difference observed in their 
birth; that after the act of insemination, sperm was carried to 
each ovary; one had matured a germ ready for fecundation, then 
impregnation and conception immediately followed, and the 
decidua of the uterus hermetically sealed both fallopian tubes, 
and thus securely retained the sperm within the other fallopian 
canal. The stimulus of the sperm so pent up, causes that ovary 
to mature a germ, although it may do so slowly, and after two 
or three months it is perfected, fertilized and a second concep- 
tion occurs within the uterus. If each embryo observes a regular 
period of growth and each be born at maturity, there must be 
an interval of two or three months between their birth. But it 
is far more common for the parturition of the first, displaying 
signs of full maturity, to be attended by the birth of a second, 
which is immature and cannot sustain respiratory life. The 
birth of the latter was brought about prematurely, by the action 
of the uterus in expelling the matured child. 
UTERINE PREGNANCY. 
301. There are many who manifest a laudable desire to un- 
derstand the physiology of conception, the changes which take 
place and the order of their natural occurrence. If impregnation 
has taken place at the ovaries or within the fallopian tubes, the 
uterus becomes conscious of the fact, and anticipates the arrival 
of the fertilized germ within its cavity, by making certain neces- 
sary preparations for its safe reception. To this end, there is 
exuded upon its inner surface a peculiar nutritious substance. It TLACENTA OR “AFTERBIRTH.” 
227 
flows out of the minute porous openings, surrounding the ter- 
mination of the fallopian tube within the uterine cavity, and thus 
is in readiness to receive the germ, and retain it there until it be- 
becomes attached. Undoubtedly the germ imbibes from this 
matter, materials for its nurture and growth. This membranous 
substance is termed the Decidua, and disappears after conception 
is insured. Two membranes form around the embryo; the inner 
one is called the Amnion, the outer one, the Chorion. Both 
serve for the protection of the embryo, and the inner one con- 
tains the liquor amnii in which it floats during intra-uterine life. 
Immediately after conception, the small glands in the neck of the 
uterus usually throw out a sticky secretion, uniting the sides of, 
or filling the canal, so that nothing may enter or leave the 
uterine cavity. 
302. The fertilized ovum rapidly develops. Undoubtedly 
after its conception, it imbibes nourishment, and without ques- 
tion there is a disposition of fluids to pass into it, through its 
delicately organized membranes. If this process is not involun- 
tary, yet at all events, it is at the convenience and use of the 
developing germ. After three months the embryo is termed the 
foetus. Its fluids are then so much more highly organized, that 
some of them are tinged with sanguine hues, and thence forward 
acquire the characteristics of red blood. Out of red blood, blood- 
vessels are formed, and from the incipient development of the 
heart, follow faint lines of arteries, and the engineers of nutri- 
tion survey a circulatory system, perfecting the vascular connec- 
tions by supplementing the arteries with a complete net-work of 
veins. 
THE PLACENTA OR “AFTERBIRTH.” 
303. Whenever conception occurs, a soft spongy substance is 
formed between the uterus and the growing ovum, called 
Placenta (a Latin word signifying a cake). It is composed of 
membrane, cellular tissue, blood-vessels and connecting filaments. 
The principal use of this organ in the latter period of pregnancy 
seems to be, to decarbonize the blood of the foetus. This is ac- 
complished on the same principle that blood is oxygenized by the 
lungs. True, air is admitted directly to the lung membranes, but 
not to the placenta, yet the blood that is oxygenized by the lungs 228 
COMMON SENSE MEDICAL ADVISER. 
circulates in the uterus, and there yields its equivalents of oxygen 
to the foetal blood in the placenta, and receives in return equal 
measures of carbonic acid. This interchange of gaseous commo- 
dities takes place in the placenta or between it and the uterus, 
the intervening membranes offering no obstacle—in fact, promot- 
ing the mutual diffusion. This decarbonizing function presup- 
poses the agency of the maternal lungs, for the purpose of 
oxidizing the mother’s blood. 
304. The nature of the union of the placenta and uterus is 
one of simple adhesion. True, in some instances morbid ad- 
hesion takes place, or a growing together in consequence of in- 
flammation, but the natural junction is one merely of contact, 
the membranes of the placenta spreading out upon the cavity of 
the uterus, so that finally the former may be entirely removed 
without a particle of disturbance or injury to the latter. For- 
merly it was supposed that the placental vessels penetrated into 
the substance of the uterus. Latterly, we know that there is no 
such continuation of the vessels of the one into the other; in 
fact, in health there is no direct vascular connection, for none is 
needed. The decarbonization of the blood requires the placental 
and uterine membranes to be in contiguous relation, i. e., in 
contact with each other. 
305. If the union w~as vascular, the mother’s blood would 
circulate in the foetal body, and the impulses of the maternal 
heart might prove too strong for the delicate organization of the 
embryo. Besides, the separation of the placenta from the 
uterus might prove fatal to both parent and offspring. The 
placenta is only a temporary organ, and when its functions are 
no longer required, is easily and safely removed. • 
UMBILICAL CORD. 
306. The foetal blood is transported to and fro between the 
body of the child and the placenta, by a cord which has two 
arteries and one vein; it is called the nmbilical cord, because it 
enters the body at the middle of the abdominal region or navel. 
It is composed also of its own proper membranous sheath or 
skin, and cellular tissues, besides the blood-vessels. Two months 
after pregnancy, this cord can be seen, when it commences to 
grow rapidly. EIGHT TO TEEMINATE PEEGNANCY. 
229 
QUICKENING. 
307. Not until the mother feels motion, is she said to be quick 
with child. That is, the child must be old and strong enough to 
communicate a physical impulse, which the mother can distinctly 
perceive, before it is regarded as having received life. This is 
another old fogy falacy, for the germ had to be endowed with 
life to commence organization. The act of impregnation com- 
municated the vital principle, and from that moment it started 
upon its career of development. A long period elapses after 
this occurs before it can make the mother feel its motions. Be- 
fore quickening, the attempt to destroy the foetus is not con- 
sidered so grave a crime by our laws, but after this quickening 
takes place, it is deemed a felony. 
RIGHT TO TERMINATE PREGNANCY. 
308. The expediency and the moral right to prematurely 
terminate pregnancy must be allowed, if weighty and sufficient 
reasons for it exist. It should never be undertaken, however, 
without the advice and approval of the family physician, and 
whenever it is possible, the counsel of another medical practi- 
tioner should be obtained. There may be so great a malforma- 
tion of the pelvic bones as to preclude delivery at full term, or, 
as in some instances, the pregnant condition may jeopardize the 
life of the mother, because she is not able to retain nourishment 
upon the stomach. Those disqualified for maternal duties, by 
whatever cause should seek counsel on this subject, from some 
well informed physician, who, if he becomes perfectly satisfied 
that conception ought to be avoided, will give such advice as may 
materially lessen the liabilities of such an undesirable event. 
309. Those who are qualified for maternal duties, should not 
undertake to defeat the intentions of nature, simply because they 
love ease and dislike responsibility. Such may be considered 
genteel ladies, but practically, they are indifferent to the claims 
of society and of posterity. How such selfishness contrasts with 
that glorious, heroic, Spartan spirit, of the young woman who 
consulted us in reference to the acceptance of a tempting oflFer of 
marriage. She was below medium size and delicately organized. 
She hesitated in her answer, because she was uncertain as to her 230 
COMMON SENSE MEDICAL ADVISEE. 
duty to herself, to her proposed husband and the prospective con- 
tingencies of matrimony. After she was told that it was doubt- 
ful whether she could discharge the obligations of maternity with 
safety to herself, and yet, that she might prove to her intended 
husband, a true and invaluable wife, she quickly answered, her 
black eyes all radiant with the high purpose of her soul: “If I 
assent to this offer, I shall accept the condition and its conse- 
quences also, even if the sequence is pregnancy, and I know it 
will cost me my life!” She acceded to the proposal and years 
found them one in happiness — then a daughter was born, but 
the bearing and nursing was too much for her delicate organiza- 
tion, and she continued to sink until she found rest in the grave. 
Of all her beautiful and noble sayings, none reflect more moral 
grandeur of spirit, than the one in which she expressed her intent 
and purpose to prove true to posterity. 
SIGNS OF PREGNANCY. 
310. The symptoms that indicate pregnancy are: cessation of 
the menses, enlargement of the mamma?, morning sickness, dis- 
tention of the abdomen and movement of the foetus. A married 
woman has a right to suspect that she may have conceived, when 
at a proper time she fails to menstruate, especially when she 
knows that she is liable to become pregnant. A second men- 
strual failure strengthens this conclusion, although there are 
many other causes that might prevent the appearance of the 
catamenia, as disease of the uterus, general debility, taking cold, 
etc., and all of these should be taken into account. In the 
absence of all apparent influences calculated to obstruct the 
menses, the presumption ordinarily is, that pregnancy is the 
cause of their non-appearance. The evidence is still more con- 
clusive, when the mammae and abdomen enlarge after experi- 
encing morning sickness. Notwithstanding all these symptoms, 
the audible sound of the heart or the movements of the foetus, 
are the only infallible signs of a pregnant condition. 
DURATION OF PREGNANCY. 
311. The ordinary duration of pregnancy is forty weeks or 
280 days. The difficulty in telling exactly when a pregnancy 
will be completed, is in not knowing precisely when it began. DURATION OF PREGNANCY. 
231 
Some gestations are more protracted than others, but the average 
duration is the time we have given. A very reasonable way to 
compute the term, is to reckon three months back fi’om the day 
when the menses ceased, and then add seven days to that time, 
which will be the date, in the following year, of the expected 
time of confinement. It is customary, also, for women to count 
from the middle of the month after the last appearance of the 
menses, and then allow ten lunar months for the term. This 
computation will prove correct, except in those instances where 
conception takes place, immediately before the last appearance 
of the catamenia. A few women can cast the time of labor 
from the occurrence of quickening — the time when they first 
feel the motion of the foetus — allowing eighteen weeks for time 
past, and at the conclusion of twenty-two more, expecting the 
confinement. With those in whom quickening occurs regularly, 
in a certain week of pregnancy, this calculation may prove nearly 
correct. 
312. The English law fixes no precise limit for the legitimacy 
of the child. In France a child is regarded as lawfully begotten, 
if born within three hundred days after the death or departure 
of the husband. There are a sufficient number of cases on record 
to show, that gestation may be prolonged two and even three 
weeks beyond the ordinary or average term. The variation of 
time may be thus accounted for; after insemination, a consider- 
able interval elapses before fecundation takes place, and the 
passage of the fertilized germ from the ovary to the uterus is 
also liable to be retarded. There are many circumstances and 
conditions which might serve to diminish its ordinary rate of 
progress, and postpone the date of conception. This would 
materially lengthen the apparent time of gestation. 
It is likewise difficult to determine the shortest period at which 
gestation may terminate, and the child be able to survive. A 
child may be born and continue to live for some months, after 
twenty-four or twenty-five weeks of gestation; it was so decided, 
at least, in an ecclesiastical trial. 
313. It will not be expected that the author will dwell min- 
utely or at length, upon the formation and growth of the foetal 
structures, and trace them separately from their origin, to their 
completion at the birth of the child. The student of medicine 232 
COMMON SENSE MEDICAL ADVISER. 
must gain information by having access to large works and ex- 
haustive treatises upon this interesting subject. 
314. Wliat trifling contingencies defeat vitality! Conception 
may be prevented by virulent secretions—disease of the reproduc- 
tive organs. Leucorrhoeal matter may destroy the life-property 
of the sperm-cells. There are many ways, even after impregna- 
tion, of compromising the existence of the frail embryo. Acci- 
dents, injuries, falls, blows, acute diseases, deficiency of nutrition 
and development, in fact, a great variety of occurrences may 
shorten the intra-u-terine career. After birth, numerous diseases 
besiege the child. By what constant care must it ever be sur- 
rounded, and how often is it snatched from the very jaws of 
death! 
What then is man but simply a germ, evolving higher powers, 
and destined for a purer, nobler existence. Ilis latent life secretly 
emerges from mysterious obscurity, is incarnated, and borne 
upon the flowing stream of time to a spiritual destination — to 
realms of immortality! As he nears those ever-blooming shores, 
the eye of faith, illumed by the inspired word, dimly discerns 
the perennial glories. Quickened by Faith, Hope and Love, his 
spirit is transplanted into the garden of paradise, the eden of 
happiness, redeemed, perfected, and made glorious in the divine 
splendor and image of Him who hath said, “ I am the Way, the 
Truth and the Life.” PAET II. 
HYGIENE. 
CHAPTER I. 
HYGIENE DEFINED.—PURE AIR. 
315. The object of hygiene is the preservation of health. 
Hitherto, we have considered, somewhat at length, the science of 
functions, or Physiology, and now, the best means to maintain 
the functional integrity of the system, appertains to Hygiene. 
It is almost impossible not to include under this head Preventive 
Medicine, the special province of which is to abate, remove or 
destroy the many causes of disease. 
316. The Greeks invested JEsculapius, (the God of Medi- 
cine), with divine honors, because he remedied and thus restored 
the sick. Hygiea, for being the protectress of health, was 
made a goddess. As male and female are one in wedlock’s func- 
tions, so Medicine and Hygiene, restoration and preservation are 
practically united. 
Hygiene inculcates sanitary discipline, medical practice, reme- 
dial discipline; hygiene prescribes healthful agencies, theory and 
practice, medicinal agencies; hygiene ministers with salubrious 
and salutary agents, medicine assuages with rectifying properties 
and qualities; hygiene upholds and sustains, medical practice 
corrects and heals; the one is preservative and conservative, the 
other curative and restorative. These discriminations are as radi- 
cal as health and sickness, as distinct as physiology and pathology, 234 
COMMON SENSE MEDICAL ADVISEE. 
and to confound them is as unnatural as to look for the beauties 
of health in the chamber of sickness. 
317. The true physician will bring to his aid, Physiology, 
Hygiene and Medicine, and usefully combine the science of the 
former with the art of the latter, that restoration may be made 
permanent, and the health preserved by the aid of hygiene. But 
when any one makes Hygiene exclusively the doctor, or deals 
wholly in hygienic regulations with little respect for physiology, 
or lavishly advertises with hygienic prefixes, we may at once 
consider it a display, not of the genuine live goddess, but only 
that of a dummy. Some of the modern hygienic twaddle about 
health is the cheapest conglomeration of the poorest kind of 
trash, expressing and inculcating more errors and whims than it 
does common sense. Persons dilate upon these subjects with 
amazing flippancy, and in some places one might imagine him- 
self surrounded by HSsculapian goddesses, whose mission was 
to traduce the profession rather than to act as “ help meets ” and 
assistants. We do not believe that there is any real contention 
going on between the true divinities of the healing art, but that 
the senseless clamor we occasionally hear comes only from the 
stampede of some routed, demoralized company of quacks. 
318. In the following pages we shall introduce to the reader’s 
attention, several important hygienic subjects, although there 
are many more that ought to receive special notice. Such as we 
do mention, demand universal attention, because a disregard of 
the conditions which we shall enumerate, is fraught with great 
evil. Our lives are lengthened or shortened by the observance or 
non-observance of the rules of common sense, and these require 
no great personal sacrifice or the practice of absurd eccentrities. 
PURE AIR FOR RESPIRATION. 
319. Perfect health requires that the air inhaled should con- 
tain at least twenty per cent, in volume, of oxygen. The venous 
blood flowing to the lungs absorbs this vivifying element, and 
returns to the heart, from which it is again sent out to stimulate 
and replenish the tissues. At each respiration the inhaled air is 
affected in a threefold manner, viz: (1.) Its oxygen is dimin- 
ished ; (2.) Its carbonic acid increased ; (3.) A certain quantity 
of watery vapor is absorbed before it is expelled from the lungs. VENTILATION OP SCHOOL ROOMS. 
235 
When the air is dry and pure, respiration will be free and per- 
fect. The existence of moisture interferes with the exhalation 
of vapor and carbonic acid. The presence of more than three 
and one-half per cent, of carbonic acid vitiates the atmosphere 
and renders it unfit for inhalation. Air in which lamps burn 
dimly has become loaded with poisonous gases. This condition 
frequently obtains in crowded lecture rooms, concert and opera 
halls; and is the cause of the faintness and languor often notice- 
able at these places of amusement. The Black Hole of Cal- 
cutta is an excellent illustration of the effect of vitiated air. 
One hundred and forty-six Englishmen were confined in a room 
eighteen feet square, with two small windows on one side to 
admit air. Ten hours after their imprisonment, only twenty-three 
were alive. 
320. Ventilation of School Hooen*. The de- 
pression and faintness from which many students suffer, after 
being confined in an ill ventilated study room, is clearly traceable 
to vitiated air, while the evil is assigned to excessive mental 
exertion. The effect of ventilation upon the health of students, 
is a subject of universal interest to parents and educators, and 
at present is receiving the marked attention of school authori- 
ties. Fredei'ick Windsor, M. D., of Winchester, made a few 
remarks pertinent to this subject in the annual report of the 
State Board of Health of Massachusetts, 1874. One of the in- 
stitutions, which was spoken of in the last report of 1873, as a 
model, in the warming and ventilation of which, much care had 
been bestowed, was visited December, 1873. The report is as 
follows: “I visited several of the rooms, and found the air 
in all, offensive to the smell, the odor being such as one would 
imagine old boots, dirty cloths and perspiration would make if 
boiled down together;” again, “in the new model school-house 
the hot air enters at two registers in the floor on one side, and 
makes (or is supposed to make) its exit by a ventilator at the 
floor, on the other side of the room.” The master said the air 
was “ supposed to have some degree of intelligence, and to know 
that the ventilator was its proper exit.” Thorough ventilation 
has been neglected by many school officials on account of the 
extra expense it incurs. In our climate, during seven months at 
least, pure atmospheric air must be paid for. The construction 236 
COMMON SENSE MEDICAL ADVISEE. 
of vertical ducts, the extra amount of fuel, and the attendant ex- 
penditures are the objections which, in the computation of many 
educators, outweigh the health and happiness of the future gen- 
eration. Three conditions are necessary for the thorough venti- 
lation of our study rooms, viz: (1.) An adequate supply of fresh 
air. (2.) It should be warmed before being admitted into the 
room, and (3), it should be discharged as contaminated, after 
its respiration. The ventilation of the school room, consists, 
like the respiratory movements, of a triple process, the warming 
and introduction of fresh air from without and the discharge of 
the respired and unwholesome air from within. This is accom- 
plished by means of doors, windows, chimneys, and lastly of 
ventilators placed, one near the level of the floor, and the other 
near the ceiling of the room. The ventilators ought to be 
arranged on the opposite sides of the room, in order to insure a 
current, and an abundant supply of air. When trustees and 
patrons learn that pure air is absolutely essential to health, and 
that their children are being slowly poisoned by the foul air of 
school-rooms, then they will construct our halls of learning with 
a just regard for the laws of hygiene, and students will not droop 
under their tasks on account of the absence of Nature’s most 
bountiful gift, pure air. 
321. Ventilation of Factories and Work- 
shops. This is a subject which demands the immediate atten- 
tion of manufacturers. The odors of oil, coal gas and animal 
effluvia render the atmosphere foul and stagnant and often give 
rise to violent diseases among the operatives. From two to four 
hundred persons are often confined in workshops, six hundred feet 
long, with no means of ventilation except windows on one side 
only. The air is breathed and re-breathed, until the operatives 
complain of languor and headache, which they attribute to “ over- 
work.” The manufacturers pompously talk of “discharge” if 
the labor paid for is not accomplished. The real cause of the 
headache and non-fulfillment of duties, is literally the inhalation 
of twenty cubic inches of poison at every expansion of the lungs. 
If the proprietors would provide efficient means for ventilating 
their workshops, the cost of construction would be repaid with 
compound interest, in the better health of their operatives. and 
the consequent increase of labor. Our manufacturers must learn SITE FOB HOMES. 
237 
and practice the great principle of political economy, viz: that 
the interests of the laborer and employer are reciprocal. 
322. Ventilation of our dwellings. Not less 
important is the ventilation of our dwellings; each apartment 
should be provided with some channel for the escape of the nox- 
ious vapors constantly accumulating. Most tenements (built by 
miserly millionaires), and occupied by the poor of our cities, are 
literally “ dens ” of poison. Their children inhale disease with 
their earliest breath. What wonder that our streets are filled 
with squalid, wan-visaged children! Charity visits these miser- 
able “Homes ”(?) bringing garments and viands to their half- 
famished inmates; but she has been slow to learn, that fresh air 
is as essential to life as food or clothing. Care should be taken 
by the public authorities of every city, that its tenement houses 
do not degenerate into foul hovels, like those of the poor En- 
lish laborer, so graphically portrayed by Disraeli. But ill-venti- 
lated rooms are not found exclusively in the abodes of the poor. 
True in the homes of luxury, the effect of vitiated air is modified 
by food, etc. Men of wealth give far more attention to the 
architecture and adornment of their houses, to costly decorations 
and expensive furniture, than to proper ventilation. Farmers 
too are derelict in the construction of their cottages. Their 
dwellings are often built, for convenience, in too close proximity 
to the barn. Because they do not construct a suitable sewer or 
drain, the filth and refuse food is £< thrown out of the back door,” 
where it undergoes putrefaction; the vitiated air penetrates the 
interior of the house, and, there being no means of ventilation, 
it remains to be respired by the occupants. The result is, that 
for the sake of saving a few dollars, which ought to be expended 
in the construction of flues and sewers, the farmer often sees the 
child he prizes far above his “ broad acres ” gradually decline, 
or suddenly fall a victim to fevers or malignant disease. Parents, 
make your homes healthy, let in the pure, fresh air and bright 
sunlight, so that your conscience may never upbraid you with 
being neglectful of the health and lives of your little ones. 
SITE FOR HOMES. 
323. Malaria. Upon the subject of constructing our 
residences, besides securing proper ventilation and adequate 238 
COMMON SENSE MEDICAL ADVISER. 
drainage, we ought to select the location for a homestead, on dry 
soil. Low levels, damp surroundings and marshy localities not 
only breed malaria and fevers, but are a prolific cause of colds, 
coughs and consumption. Some care should be taken not to 
locate a dwelling where the natural currents of air, or high winds, 
will be likely to bring the poison of decayed vegetable matter 
from low lands. Certain brooks, boggy land, ponds, foggy lo- 
calities, too much shade, all these are favorable to the develop- 
ment of disease. Then the walls of a building should be so 
constructed as to admit air between the exterior and interior 
surfaces, otherwise the interior of the house will be damp and 
unwholesome. In the dead of winter, in northern latitudes, the 
house ought to be kept slightly tempered with warmth, both 
night and day, a condition very favorable to the introduction 
and change of atmospheric currents. The invigorating tenden- 
cies of a dry, pure atmosphere are remarkably beneficial, while 
air charged with moisture and decay is exceedingly baneful, 
introducing diseases under various forms. 
324. Neither should the dwelling be shaded by dense foliage. 
The dampness of the leaves tends to attract malaria. Trees 
growing a little distance from the house however, have the power 
of obstructing the transmission of unhealthy vapors arising be- 
yond them. Malaria generally travels near the surface of the 
earth, and seems to be more abundant in the night time. Persons 
sleeping in the upper story of a house may escape its morbid 
influence, while those occupying apartments on the lower floor, 
become affected. 
DAMP CELLARS. 
325. Damp cellars, under residences, are a fruitful cause of 
disease. Dr. Sanford B. Hunt, in an article appearing in the 
Newark Daily Advertiser, speaking of the recent epidemic of 
diphtheria in New York City, says: 
“Pestilences that come bodily, like cholera, are faced and 
beaten by sanitary measures. Those which come more subtly 
need for their defeat only a higher detective ability and a closer 
study of causes, many of which are known, but hidden under the 
cellars of our houses, and which at last are only preventable 
by public authority and at public expense in letting out the DUST AND DISEASE. 
239 
imprisoned dampness which saturates the earth on which our 
dwellings are built. Where wood rots, men decay. This is 
clearly shown in the sanitaiy map printed in the Times. In the 
great district surrounding Central Park, and which participates 
in its drainage system, there are no cases. On the whole line of 
Fifth Avenue there are none. The exempt districts are clearly 
defined by the character of the soil, drainage, and sewerage, 
and by the topography, which either has natural or artificial 
drainage, but most of which is so dry that only surface-water 
and house-filth — which does not exist in those palaces — can 
affect the health of the residents. But in the tenement houses 
and on the made lands where running streams have been filled in 
and natural springs choked up by earth fillings, diphtheria finds 
a nidus in which to develop itself. The sanitary map coincides 
precisely with the topographic map made by Gen. Yiele. Where 
he locates buried springs and water-courses, there we find the 
plague spots of diphtheria and in the same places, on previous 
maps prepared by the Board of Health, we find other low types 
and stealthy diseases, such as typhoid and irruptive fevers, and 
there we shall find them again when the summer and autumnal 
pestilences have yielded place to those which belong to the indoor 
poisoned air in the winter. The experience of other cities, nota- 
bly London and Dublin, once plague spots and now as healthy 
as any spot on earth, proves that most of the causations of dis- 
ease are within the control of the competent sanitary engineer, 
even in localities crowded beyond American knowledge, and 
houses built upon soil saturated for centuries with the offal of 
successive and uncleanly generations. Wet earth, kept wet by 
the boiling up of imprisoned springs, is a focus of disease. Dry 
earth is one of the most perfect deodorizers, the best of oxydizers 
and absorbents, destroying the germs of disease with wonderful 
certainty. On those two facts rests the theory of public hygiene.” 
DUST AND DISEASE. 
326. The air we hreathe is heavily loaded with minute particles 
of floating dust, their presence being revealed only by intense 
local illumination. Professor Tyndall says: “solar light, in 
passing through a dark room, reveals its track by illuminating 
the dust floating in the air. ‘ The sun,’ says Daniel Culverwell, 240 
COMMON SENSE MEDICAL ADVISER. 
‘discovers atoms, though they be invisible by candle-light, and 
makes them dance naked in his beams.’ ” 
327. After giving the details and results of a series of expe- 
riments in which he attempted to extract the dust from the air 
of the Royal Institute by passing it through a tube containing 
fragments of glass wetted with concentrated sulphuric acid, and 
thence through a second tube containing fragments of marble 
wetted with a strong solution of caustic potash, which experi- 
ments were attended with perfect failure, the professor contin- 
ues, “I tried to intei'cept this floating matter in various ways; 
and on the day just mentioned, prior to sending the air through 
the drying apparatus, I carefully permitted it to pass over the 
tip of a spirit-lamp flame. The floating matter no longer ap- 
peared, having been burnt up by the flame. It was, therefore, 
of organic origin. I was by no means prepared for this result; 
for I had thought that the dust of our air was, in great part, 
inorganic and non-combustile.” In a foot note he says “accord- 
ing to an analysis kindly furnished me by Dr. Percy, the dust 
collected from the walls of the British Museum contains fully 
fifty per cent, of inorganic matter. I have every confidence in 
the results of this distinguished chemist; they show that the 
floating dust of our rooms is, as it were, winnowed from the 
heavier matter.” Again he says: “the air of our London rooms 
is loaded with this organic dust, nor is the country air free from 
its presence. However ordinary daylight may permit it to dis- 
guise itself, a sufficiently powerful beam causes dust suspended 
in air to appear almost as a semi-solid. Nobody could, in the 
first instance, without repugnance, place the mouth at the illu- 
minated focus of the electric beam and inhale the thickly-massed 
dust revealed there. Nor is the repugnance abolished by the 
reflection that, although we do not see the floating particles, we 
are taking them into our lungs every hour and minute of our 
lives.” “The notion was expressed by Kircher and favored by 
Linnaeus, that epidemic diseases are due to germs which float in 
the atmosphere, enter the body, and produce disturbance by the 
development within the body of parasitic life. While it was 
struggling against great odds, this theory found an expounder 
and a defender in the President of this institution. At a time 
when most of his medical brethren considered it a wild dream, Sir COTTOST-WOOL RESPIRATOR. 
241 
Henry Holland contended that some form of the germ-theory 
was probably true.” Professor Tyndall proposes means by the 
application of which air loaded with noxious particles may be 
freed from them before entering the air passages. The following 
embodies his suggestions on this point: 
328. “ I now empty my lungs as perfectly as possible, and 
placing a handful of cotton-wool against my mouth and nostrils, 
inhale through it. There is no difficulty in thus filling the lungs 
with air. On expiring this air through a glass tube, its freedom 
from floating matter is at once manifest. From the very be- 
ginning of the act of expiration the beam is pierced by a black 
aperture. The first puff from the lungs abolishes the illuminated 
dust, and puts a patch of darkness in its place; and the darkness 
continues throughout the entire course of the expiration. When 
the tube is placed below the beam and moved to and fro, the 
same smoke-like appearance as that obtained with a flame is 
observed. In short, the cotton-wool, when used in sufficient 
quantity, and withdue care, completely intercepts the floating 
matter on its way to the lungs. 
COTTON-WOOL RESPIRATOR 
The application of these experiments is obvious. If a physi- 
cian wishes to hold back from the lungs of his patient, or from 
his own, the germs or virus by which contagious disease is pro- 
pagated, he will employ a cotton-wool respirator. If perfectly 
filtered, attendants may breathe the air unharmed. In all proba- 
bility the protection of the lungs and mouth will be the protection 
of the entire system. For it is exceedingly probable that the 
germs which lodge in the air-passages, or find their way with the 
saliva into the stomach with its absorbent system, are those 
which sow in the body epidemic disease. If this be so, then 
disease can be warded off by carefully prepared filters of cotton- 
wool. I should be most willing to test their efficacy in my own 
person. But apart from all doubtful applications, it is perfectly 
certain that various noxious trades in England may be rendered 
harmless by the use of such filters. I have had conclusive evi- 
dence of this from people engaged in such trades. A form of 
respirator devised by Mr. Garrick, a hotel proprietor in Glasgow, 
in which inhalation and exhalation occur through two different 242 
COMMON SENSE MEDICAL ADVISEE. 
valves, the one permitting the air to enter through the cotton- 
wool, and the other permitting the exit of the air direct into the 
atmosphere, is well adapted for this purpose. But other forms 
might readily be devised.” 
LIGHT AND HEALTH. 
329. Our dwellings ought freely to admit the sunlight. Dis- 
eases which have baffled the skill of physicians have been known 
to yield when the patients were removed from dark rooms to 
light and cheerful apartments. Lavoisier placed light, as an 
agent of health, even before pure air. Plants that grow in the 
shade are slender and weak, and children bi*ought up in dark 
rooms are pale, sallow and rickety. It is a false idea that would 
avoid sunlight for fear of spoiling the complexion, when the 
sun’s rays are necessary to give to it the delicate tinting of beauty 
and health. Air is necessary to the first inspiration and the last 
expiration of our lives, but the purity and activity of the atmos- 
phere depends upon the warming rays of the sun, while our 
bodies require light for their healthful stimuli. We know that 
without solar light, there can be no proper vegetable growth, and 
it is equally necessary for the beauty and perfection of animal 
development. Our dwellings should therefore be well lighted 
and made as bright and cheerful as possible. Women who cur- 
tain the windows, soften the light and tint the room with some 
mellow shade, may do so in order to hide their own faulty com- 
plexions. The skin of those who work in dungeons or in deep 
mines becomes pale*or sickly yellow, the blood grows watery, 
the skin blotches and dropsy intervenes. On the other hand, 
invalids carried out from darkened chambers into the bright 
sunlight are stimulated, the skin browns, nutrition becomes more 
active, the blood improves and they grow convalescent. Light 
is especially necessary for the healthy growth of children. There 
is nothing more bountiful and gladdening than the glorious sun- 
light. Let its luminous, warming and physiological forces come 
freely into our dwellings, enter into the chemistry of life, ani- 
mate the spirits, and pervade our homes and our hearts with its 
joy-inspiring and health-imparting influences. CHAPTER II. 
FOOD. BEVERAGES. 
CLOTHING. 
330. The human body is continually undergoing changes, 
which commence with the earliest dawn of existence and end 
only with death. The old and worn out materials, are constantly 
being removed to make room for the new. Growth and develop- 
ment, as well as the elimination of worn out and useless matter, 
continually require new supplies, which are to be derived from 
our food. To fulfill this requirement it is necessary that the 
nutriment should be of the proper quality, and of sufficient 
variety to furnish all the constituents of the healthy body. In 
order that food may be of utility, like other building materials, 
it must undergo preparation; the crude substance must be worked 
up into proper condition and shape for use, in other words it 
must be digested. But this does not end the process of supply; 
each different substance must be taken by the different bands of 
workmen, after due preparation in the work shop, to its appro- 
priate site in the structure and there fitted into its proper place; 
this is assimilation. In reality it becomes a portion of the body 
and is advantageous in maintaining the symmetry and usefulness 
of the part to which it is assigned; this constitutes the ultimate 
object of food — nutrition. 
331. Eating1 is the process of receiving the food into the 
mouth, i. e., prehension,' minutely dividing and mixing it with 
the saliva — mastication and insalivation; conveying it to the 
stomach — deglutition. Plenty of time should be taken, at meals, 
to thoroughly masticate the food and mix it with the saliva, which 244 
COMMON SENSE MEDICAL ADVISER. 
being one of the natural solvents, favors its farther solution by 
the juices of the stomach; the healthy action of the digestive 
powers is favored by tranquility of mind, agreeable associations 
and pleasant conversation while eating. It is proverbial of the 
American people that they bolt their food whole, washing it 
down with various fluids, thus forcing the stomach to perform 
not only its own duties, but also those of the teeth and salivary 
glands. This manner of dispatching food, which should go 
through the natural process above described, is not without its 
baleful consequences, for the Americans are called a nation of 
dyspeptics. 
Eating slowly, masticating the food thoroughly, and drinking 
but moderately during meals, will allow the juices of the stomach 
to fulfill their proper function, and healthy digestion and nutri- 
tion will result. If the food is swallowed nearly whole, not only 
will a longer time be required for its solution, but oftentimes it 
will ferment and begin to decay before nutritive transformation 
can be effected, even when the gastric juice is undiluted with 
the fluids which the hurried eater imbibes during his meal. 
332. Regularity Of Meals cannot be too strongly 
insisted upon. The stomach, as well as other parts of the body, 
must have intervals of rest or its energies are soon exhausted, 
its functions impaired, and dyspepsia is the result. Nothing of 
the character of food should ever be taken except at regular meal 
times. Some persons are munching cakes, apples, nuts, candies, 
etc., at all hours, and then wonder that they have weak stomachs. 
They take their meals regularly, and neither eat rapidly nor too 
much, and yet they are troubled with indigestion. The truth is 
they keep their stomachs almost constantly at work, and hence 
tired out, which is the occasion of the annoyance and distress 
they experience. 
333. Eating too much. It should always be remem- 
bered that the nutrition of our bodies “ does not depend upon 
the amount eaten, but upon the amount that is digested.” Eat- 
ing too much is about as bad as swallowing the food whole. 
The stomach is unable to digest all of it, and it ferments and 
gives rise to unpleasant results. The unnatural distention of the 
stomach with food causes it to press upon the neighboring or- 
gans, interfering with the proper performance of their functions, 245 
FEEDING INFANTS. 
and if frequently repeated gives rise to serious disease. People 
eat too much, oftener than too little, and to omit a meal when 
the stomach is slightly deranged, is frequently the best medicine. 
To rise from the table before the desire for food is quite satisfied, 
is an excellent plan. 
334. Fate Slippers. It is generally conceded by good 
authority that late suppers are injurious, and should never be 
indulged in. Persons who dine late, have little need of food 
after their dinner, unless they are to be kept up until a late hour. 
In such cases a moderate meal may be allowable, but it should 
be eaten two or three hours before retiring. Those who dine in 
the middle of the day should have supper, but sufficiently early 
that a proper length of time may elapse before going to bed, in 
order that active digestion may not be required during sleep. 
On the other hand it is not advisable to go wholly without this 
meal, but the food eaten should be light, easily digestible, and 
moderate in quantity. Persons who indulge in hearty suppers at 
late hours, usually experience a poor night’s rest, and wake next 
morning unrefreshed, with a headache, and a deranged stomach. 
Occasionally more serious consequences follow; gastric disorders 
result, apoplexy is induced; or perhaps the individual never wakes. 
335. Feeding Infants. For a't least six or seven 
months after birth, the most appropriate food for an infant is its 
mother’s milk, which, when the parent is healthy, is rich in all 
the elements necessary for its growth and support. Next to the 
mother’s milk, that of a healthy nurse is to be preferred: in the 
absence of both, milk from a cow that has recently calved is the 
most natural substitute, in the proportion of one part water to 
two parts milk slightly sweetened. The milk used should be 
from but one cow. All sorts of paps, gruels, panadas, cordials, 
laxatives, etc., should be strictly prohibited, for their employ- 
ment as food cannot be too severely censured. Vomiting, diar- 
rhoea, colic, green stools, griping, etc., are the inevitable results 
of their continued use. The child should be fed at regular 
intervals, of about two hours, and be limited to a proper amount 
each time, which, during the first month, is about two ounces. 
From 11 P. M. to 5 A. M. the child should be nursed but 
once. As the child grows older the intervals are to be length- 
ened, and the amount taken at a time gradually increased. The 246 
COMMON SENSE MEDICAL ADVISER. 
plan of gorging the infant’s stomach with food every time it 
cries, cannot be too emphatically condemned. 
336. After the sixth or seventh month, in addition to milk, 
bits of bread may be allowed, slowly increasing the quantity, 
thus permitting the diet to change gradually from fluid to solid 
food, so that when the teeth are sufficiently developed for mas- 
tication, the child has become accustomed to various kinds of 
nourishment. Over-feeding, and continually dosing the child 
with cordials, soothing syrups, etc., are the most fruitful sources 
of infant mortality and should receive the condemnation of every 
mother in the land. 
337. Preparation Of Food. The production of pure 
blood requires that all the food selected should be rich in nutri- 
tious elements, and well cooked. To announce a standard by 
which all persons shall be guided in the selection and prepara- 
tion of their food is impossible. Especially does this apply in a 
country, the inhabitants of which represent almost every nation 
on the face of the globe. Tourists are aware that there is as 
much diversity in the ai-ticles of food and methods of cookery, 
among the various nationalities, as in the erection of dwellings 
and their varied mental characteristics. In America we have 
a conglomeration of all these peoples; and for a Yankee to con- 
struct rules of cookery for his German, French, English, Welsh 
and Irish neighbors, or vice versa, is useless, for neither profits 
by, and seldom reads them. There are, however, certain condi- 
tions recognized by the hygienists of every nation. The ade- 
quate nutrition of the organic tissues demands a plentiful supply 
of pure blood, otherwise the digestive apparatus will become 
impaired, the mental processes deranged, and the entire bony and 
muscular systems will lose their strength and elasticity, and be 
incapacitated for labor. 
338. Different Kinds of Food Required. The 
different periods and circumstances of life, require their appro- 
priate food, and the welfare of mankind demands that it should 
supply both the inorganic and organic substances employed in the 
development of every tissue. The inorganic elements employed 
in our construction of which Phosphorus, Sulphur, Soda, Iron, 
Lime and Potash are the most prominent, are not considered 
as aliments, but are found in the organic kingdom, variously DIFFERENT KINDS OF FOOD REQUIRED. 
247 
arranged and combined with organic materials in sufficient quanti- 
ties for ordinary purposes. When, however, from any cause, a 
lack of any of these occurs, so that their relative normal propor- 
tions are deranged, the system suffers, and restoration to a 
healthy condition can only be accomplished by supplying the 
deficiency; this may be done by selecting the article of food 
richest in the element which is wanting, or by introducing it as a 
medicine. It must be remembered, that those substances which 
enter into the construction of the human fabric, are not promis- 
cuously employed by nature, but that each and every one is 
destined to fulfill a definite indication. 
339. Lime enters largely into the formation of hone, either 
as a 2>hosphate or a carbonate, and is required in much greater 
quantity in early life while bone is undergoing development, than 
afterwards. In childhood the bones are composed largely of 
animal matter, being pliable and easily moulded. For this reason 
the limbs of young children bend under the weight of their 
bodies and unless care is taken they become “ bow-legged ” and 
distorted. Whenever there is a continued deficiency of the 
earthy constituents (see *[ 30) disease of the bones will follow. 
Therefore, during childhood and particularly during the period 
of dentition (teething), the food should be nutritious and at the 
same time contain a due proportion of lime, which is preferable 
in the form of a phosphate. When it cannot be furnished by 
the food, it should be supplied artificially. Delayed, prolonged 
and tedious dentition generally arises from a deficiency of lime. 
With the advance of age it accumulates and the bone be- 
comes hard, inelastic, and capable of supporting heavy weights. 
Farther on, as in old age, the animal matter of bone becomes 
diminished, and lime takes its place so that the bones become 
brittle and are easily broken. Lime exists largely in “hard 
water ” and to a greater or less extent in milk, and in nearly all 
foods, except those of an acid character. 
340. Phosphorus exists in various combinations in different 
parts of the body, particularly in the brain and nervous system. 
Persons who perform a large amount of mental labor require 
more phosphorus than those engaged in other pursuits. It 
exists largely in the hulls of wheat, in fish and in eggs. It 
should enter to a considerable extent into the diet of brain 248 
COMMON SENSE MEDICAL ADVISER. 
workers, and the bread consumed by them should be made of 
unbolted meal. 
341. Sulphur, Iron, Soda and Potash are all necessary in the 
various tissues of the body, and deficiency of any one of them, 
for any considerable length of time, results in disease. They are 
all supplied, variously arranged and combined, in both animal 
and vegetable food; in some articles they exist to considerable 
extent, in others in much smaller quantities. Sulphur exists in 
eggs and flesh of animals, and often in water. Iron exists in the 
yolk of eggs, in flesh, and in several vegetables. Soda is supplied 
in nearly all food and largely in common salt, which is a com- 
position of sodium and muriatic acid, the latter entering into the 
gastric juice. Potash exists in some form or other, in sufficient 
quantities for health, in both vegetable and animal food. 
342. Principles Of Food. Food is separated into two 
grand divisions, viz: Nitrogenized compounds, or those which 
contain nitrogen, and produce blood and llesh, and Non-nitro- 
genized compounds which do not contain nitrogen, and produce 
heat. The non-nitrogenized, or heat producing compounds, are 
divided into the Saccharine and Oleaginous groups: The first 
group is composed of starch, sugar, gum and woody fibre; the 
second of fatty substances, no matter from whence derived. 
Though they may present different appearances, they are analo- 
gous in character, all containing Oxygen, Hydrogen and Carbon 
in various proportions. They support combustion and produce 
animal heat, but do not enter into the formation of blood or 
flesh. Man cannot live on them alone, neither can he well live 
without them. The nitrogenized compounds are also divided 
into two groups, the Albuminous and the Gelatinous : The first 
group is derived from both animal and vegetable substances, 
the white of the egg being its type. The second group is de- 
rived only from animal bodies. It matters not from whence 
either are derived, they are analogous in their character, contain 
Oxygen, Hydrogen, Carbon and Nitrogen in various combina- 
tions, and make up the blood and tissues of the body. 
343. Variety of Food Necessary. Scientifically 
conducted experiments have demonstrated that a variety of food 
is necessary for health. Animals, fed exclusively upon that 
which will produce a single proximate principle, or even upon a VALUE OF ANIMAL FOOD. 
249 
single article of diet, droop and die; and in the human family, 
we know that the constant use of one kind of diet causes disgust, 
even when not very long continued. Consequently we infer, 
that the welfare of man demands, that his food be of sufficient 
variety to supply his body with all of its component parts. If 
this is not done the appetite is deranged, and often craves the 
very article which is necessary to supply the deficiency. 
344. Properties Of Food. Food may be divided 
into three classes; the Carbonaceous, or non-nitrogenized, the 
Nitrogenous, or nitrogenized, and the Phosphatic, which may 
occur combined with the others. The first variety furnishes the 
heat, the second the strength, and the third the brain power. A 
preponderance of one class of food over the others may be ren- 
dered necessary by the circumstances surrounding the individual. 
Mental labor requires a preponderance of the phosphatic, manual 
labor of the nitrogenous, while persons subjected to low tem- 
peratures require more of the carbonaceous. 
345. Climate exerts not a little influence upon the require- 
ments of man. In northern latitudes the inhabitants are sub- 
jected to extreme cold, and require heat producing food. For 
this purpose fat and sweet ai’e eaten with avidity, and even oil is 
taken with a relish, while in warm climates, such substances are 
not necessary, nor are they generally acceptable. In our own 
climate, during the winter season, more carbonaceous material is 
taken and assimilated by the same persons than in summer; if 
such a diet were continued, the bad effects would be seen in the 
general derangement of the stomach and biliary organs, and in 
eruptions on the skin. 
346. Value Of Animal Food. The principal animal 
food of this country consists of Pork, Mutton, Beef and Fish, 
and Dr. Dio Lewis, who is considered good authority on the sub- 
ject, gives the following classification to express their relative 
values for the production of heat, muscle and brain power: 
For Heat — Pork, Mutton, Beef, Fish. 
For Muscle — Beef, Mutton, Fish, Pork. 
For Bkaist — Fish, Beef, Mutton, Pork. 
Thus it will readily be seen that while pork is richest in heat 
and fat producing material (carbon), it is of little, or no value 
whatever in the production of brain power. Beef and mutton 250 
COMMON SENSE MEDICAL ADVISER. 
are rich in muscle producing material (nitrogen), but are inferior 
to pork for the production of heat. Fish is of little value as a 
heat producer, but outranks the others as brain nutriment, next 
to which we find beef and mutton. Although pork is extensively 
produced in some portions of this country, and enters largely 
into the diet of some classes, yet its use, except in winter, is not 
to be encouraged. The same amount of capital invested in beef 
would give far greater returns in muscular power. Nearly all 
articles of diet contain, to some extent, the non-nitrogenized 
compounds; the same articles that contain nitrogen, often con- 
tain sufiicient fat and starch to fulfill ordinary requirements, 
consequently as a rule a non-nitrogenous diet is seldom necessary. 
Milk is rich in all materials, particularly the carbonaceous. 
347. Relative Values Of Food. The following table, 
which we regret could not have been more complete, shows the 
COMPOSITION OF 
FOOD 
IN 100 PARTS. 
Nitrogenous 
Flesh-formi’g 
Ingredients. 
Non-Azotized 
Heat-giving 
Principles. 
Mineral 
Blatter. 
Carbon. 
Phosphorus. 
Water. 
Milk, 
4.50 
22.30 
8.36 
14.00 
17.00 
14.00 
13.60 
10.71 
23.40 
5.43 
1.41 
1.48 
1.64 
1.75 
0.00 
0.00 
31.02 
2.3 
12.6 
1.7 
2.02 
5. 
3.014 
3.752 
2.16 
7.90 
14.30 
62.50 
7.00 
66.00 
68.50 
70.30 
72.25 
60.00 
84.65 
22.10 
11.61 
10.00 
4.05 
100.00 
100.00 
25.30 
0.66 
0.50 
0.50 
1.00 
0.70 
2.00 
3.30 
1.04 
2.50 
0.52 
1.00 
0.81 
1.62 
2.20 
0.00 
0.00 
4.90 
1.62 
6.94 
21.56 
53.92 
9.15 
45.50 
40.50 
44.10 
36.41 
35.70 
36.00 
12.20 
5.40 
5.20 
2.65 
42.58 
79.00 
36.80 
46.1 
50.7 
46.2 
0.056 
87.00 
60.8 
55.3 
80. 
14.73 
15.00 
15.00 
18. 
16. 
6.00 
75.9 
83. 
92.5 
91.5 
5. 
15.0 
40. 
14.5 
15.8 
16.6 
13.2 
14.11 
80. 
60.8 
77. 
Butchers’ meat free from bone, 
Bacon, Pork, ... ... 
Fish, 
Flour,.. . 
Barley Meal, 
Oat Meal, 
Indian Meal, 
.164 
Peas, 
B ice, 
. .286 
10 .088 
.025 
Potatoes, 
Carrots, 
Turnips, 
Cabbage, 
Sugar, 
Suet, Fat, Butter, 
Cheese, 
Wheat, 
.198 
.132 
. .132 
CO .919 
to -022 
t0 .132 
Oats, 
Bye, 
Barley, _ 
Beans, 
38.24 
10.93 
13.6 
18.18 
Blood, 
23.00 
.0143 
Fresh meat free from fat,. 
Eggs, 
„ . 
1.4 RELATIVE VALUES OF FOOD. 
251 
relative proportions of nitrogenized or muscle producing material, 
non-nitrogenized or heat and fat producing material, also known 
as carbonaceous food, and the amount of phosphorus or brain 
nutriment as well as the proportion of water. There are many 
other articles of diet which experience has proven to be rich in 
certain elements, although the proportions have not as yet been 
determined. 
Meats have already,been considered with reference to their 
nutritive value, (see 1” 346). In addition to those mentioned, 
Wild Game furnishes palatable, nutritious, and easily digested 
food. Barn-yard Fowls, when young, are excellent, and with 
the exception of geese and ducks, are easily digested. Wild 
Birds are considered much healthier than those which are 
domesticated. All of these contain more or less of the elements 
which enter into the composition of the three classes of food. 
Wheat is rich in all the elements that compose the four groups 
(see 342) and when the flour is unbolted it is one of the best 
articles to supply all the elements. 
Barley stands next to wheat in nutriment, but is not so 
palatable. 
Oats are rich in all the necessary elements of nutrition. They 
unite the four nutritive groups (see 342) in greater proportion 
than any other known vegetable. They are a great favorite 
among the Scotch as an article of diet, and, judging from their 
hardy constitutions, their choice is well founded. They supply 
the horse with animal heat as well as great muscular power. In 
consequence of the large proportion of phosphorus contained, 
they are capable of furnishing a vast amount of brain power. 
Bye is nutritive, and as a heat producer is equal to wheat, but 
it is not so rich in muscle forming material. 
Indian Corn is an article well known and extensively used 
throughout the United States and is a truly valuable one, capable 
of being prepared in a great variety of ways for food. It con- 
tains more of the carbonaceous material than wheat, and less of 
the nitrogenous and phosphatic, though enough of both to be 
extremely valuable. The proportion of phosphatic elements, 
however, is less than that of the nitrogenous. 
Buckwheat, like the potato, is poor in such nutritious qualities 
as fat, sugar and starch, but tolerably well supplied with salts. COMMON SENSE MEDICAL ADVISEE 
Bice is rather meager in nutriment; it contains but little 
phosphatic matter, with less carbonaceous than the others, and is 
best and most generally employed as a diet in tropical countries; 
it is, however, eaten with meats or milk to supply the necessary 
muscular tissue, which it does but feebly. 
Beans and Peas are rich in muscle forming matter, and furn- 
ish the manual laborer with a cheap and nutritious diet; the 
brain worker, however, would starve on them. 
Potato is over three-fourths water, and is poor in all the ele- 
ments of nutrition, but it is a very palatable article of diet, and 
is largely used; it is excellent to furnish bulk, but both the 
mental and manual laborer would break down if confined 
exclusively to this food. 
Turnip and Cabbage are 92.5 per cent, water and conse- 
quently poor in nutrition, though they are very palatable. The 
solid, portions of cabbage, however, are rich in albumen. 
348. Ifiaantity of Food Necessas’y. While we 
have advised against eating too much, it may be well to advise 
the use of enough; the occupation will influence, to a great ex- 
tent, the amount required; the manual laborer will need more 
than one who leads a sedentary, studious life. It seems to be 
instinctively demanded that the individual have enough with 
which to “fill up;” when animals are fed on substances rich in 
nutrition, they seek something else upon which to complete the 
filling up process. When a scarcity of food exists among the 
Indians, they mix it with woody fibres of roots to give the 
stomach the proper degree of distention, even though they con- 
tain no nourishment whatever. An Indian being asked why he 
did this, replied, “me don’t know, must have the belly full.''' 
349. Digestibility of Food. Unless ail article of 
diet can "be digested it is of no value, no matter how rich it may 
be in nutriment. The quantity of food taken, will influence to a 
considerable extent, the time consumed in its digestion. The 
stomachs of all are not alike in this respect, and the subject of 
time has been a difficult one to determine. The experiments of 
Ur. Beaumont with the Canadian St. Martin who discharged 
the contents of a loaded gun into his stomach, creating an ex- 
ternal opening through which the process of digestion could be 
observed, have furnished us with the following table, which is COOKERY, 
253 
near enough correct to show relatively, if not absolutely, the 
time required for the digestion of various articles: 
Articles. 
Preparat’ns 
Time 
Articles. 
Preparat’ns 
Time 
Rice, 
Boiled, .. 
66 
66 
66 
Fried, ... 
Raw, 
Broiled.. 
Boiled, .. 
Raw, 
66 
Boiled, .. 
Raw, 
Broiled.. 
Boiled, .. 
66 
Raw, 
Roasted,. 
Boiled, .. 
Roasted,. 
Baked, .. 
Boiled, .. 
Roasted,. 
Warmed, 
Broiled _. 
Roasted,. 
Baked, .. 
Raw, 
Boiled, .. 
Baked, .. 
Fricasse’d 
Raw, 
66 
Broiled.. 
Roasted,. 
Broiled _. 
Baked, .. 
Boiled, .. 
B’l’d, soft, 
Broiled.. 
Boiled, ._ 
h. m. 
1 — 
1 — 
1 — 
1 30 
1 30 
1 30 
1 35 
1 45 
2 — 
2 — 
2 — 
2 — 
2 — 
2 — 
2 — 
2 15 
2 18 
2 25 
2 30 
2 30 
2 30 
2 30 
2 30 
2 30 
2 30 
2 30 
2 30 
2 30 
2 45 
2 45 
2 50 
2 55 
3 — 
3 — 
3 — 
3 — 
3 — 
3 — 
3 — 
3 — 
Pork, recently salted 
Soup, chicken, 
Raw, 
Boiled, .. 
Roasted,. 
Broiled.. 
66 
Baked, ” 
Roasted,. 
Boiled, .. 
Broiled.. 
Roasted,. 
Baked, .. 
Melted,.. 
Raw, 
Hard bl’d 
Fried, ... 
66 
Stewed,.. 
Boiled, .. 
66 
66 
66 
66 
66 
Fried, 
Boiled, .. 
Roasted,. 
Broiled.. 
Boiled, .. 
Boiled, .. 
Fried, 
Boiled, _. 
Fried, ... 
Boiled, _. 
Roasted,. 
Boiled, .. 
66 
Fried, 
Roasted,. 
Boiled, -. 
66 
h. in. 
3 — 
3 — 
3 15 
3 15 
3 15 
3 15 
3 15 
3 15 
3 20 
3 30 
3 30 
3 30 
3 30 
3 30 
3 30 
3 30 
3 30 
3 30 
3 30 
3 30 
3 30 
3 45 
3 45 
4 — 
4 — 
4 — 
4 — 
4 — 
4 — 
4 — 
4 15 
415 
4 30 
4 30 
4 30 
4 30 
4 30 
5 15 
5 30 
5 30 
Rigs’ feet, soused,.. 
Tripe, soused, 
Oysters, fresh, 
Trout, salmon, fresh 
66 66 66 
Apples, sweet, mel’w 
Venison, steak, 
Pork, recently salted 
Pork steak, 
Corn bread, 
Mutton, fresh, 
Sago, 
Carrot, orange, 
Apples, sour, mellow, 
Cabbage,with vin’gr 
Codfish, cured, dry,. 
Eggs, fresh, 
Sausage, fresh, 
Beef, fresh, lean, dry 
Bread,wheat, fresh,. 
Butter, 
Liver, beef’s fresh, . 
Milk, 
Cheese, old, strong,. 
E°'2’S, fresh, 
Tapioca, 
6 6 66 
Milk, 
Flounder, fresh, 
Oysters, fresh, 
Turkey, wild, 
6 6 4/7 4 6 
Potatoes, Irish, . .. 
“ domesticated 
Potatoes, Irish,. 
Soup, mutton, . 
“ oyster,.. 
Parsnips, 
Turnip, flat, 
Pig, sucking,. 
Beets, 
Meat hashed with ? 
vegetables, ) 
Lamb, fresh, 
Corn, green, & beans 
Beef, fresh, lean,... 
Fowls, domestic, 
66 6 6 
Veal, fresh, 
Cake, sponge, 
Cabbage-head, 
Beans, pod, 
Soup, beef,vegeta- ) 
bles, and bread, \ 
Salmon, salted, 
Custard, . 
Chicken, full-grown 
Apples, sour, hard,.. 
Oysters, fresh, 
Heart, animal, 
Beef, old, hard, salted 
Pork, recently salted 
Cabbage, with vin’gr 
Ducks, wild, 
Bass, striped, fresh,. 
Beef, fresh, lean, rare 
“ steak,. 
Pork, recently salted 
Suet, mutton, 
Corn cake, .. 
Dumpling, apple, 
Eggs, fresh, 
Mutton, fresh, 
Veal,fresh, 
Pork,fat and lean,.. 
Suet, beef, fresh, 
Tendon, 
6 6 7 6 6 
350. Cookery. “Cookery,” says Mrs. Owen, “Is the art 
of turning every morsel to the best use; it is the exercise of skill, 
thought and ingenuity to make every particle of food yield the 
utmost nourishment and pleasure, of which it is capable.” We 
are indebted to this practical woman for many valuable sugges- 
tions in this art; and some of our recommendations are drawn 
from her experience. 254 
COMMON SENSE MEDICAL ADVISER. 
351. Soups. The tone and sweetness of soup depends, 
first, upon the meat being fresh; second, the manner in which 
it is boiled. (If it is dropped into boiling water, the juices of 
the meat coagulate, and consequently, the soup will not be as 
nutritious.) Third, soups must be nicely and delicately seasoned, 
according to the taste of the consumer, by using parsley, sage, 
savory, thyme, sweet majoram, sweet basil, or any of the vege- 
table condiments. These may be raised in the garden, or ob- 
tained at the drug stores, sifted, and prepared for use. 
352. ISecf Soup may be made of any bone of the beef by 
putting it in cold water, adding a little salt, and skimming it 
well just before it boils. If a vegetable flavor is desired celery, 
carrots, onions, turnips, cabbage or potatoes can be added, enough 
of each to suit the taste. 
For dumplings, mix and beat up together milk, flour, and a 
spoonful of butter, until it is of a consistency stiffer than is re- 
quired for batter-cakes. Drop the dumplings into boiling soup, 
and let them remain eight or ten minutes. 
353. Mutton Soup may be made from the fore quarter, 
in the same manner as above given, thickening with pearl-barley 
or rice, and flavoring to suit the taste. 
354. ISoiled Fish. Clean the fish nicely, then sprinkle 
flour on a cloth and wrap around it; salt the water, and when it 
boils, put in the fish; let it boil half an hour, then carefully 
remove it to a platter, adding egg sauce and parsley. For 
baJcing fish, prepare by cleaning, scaling, etc., and let them 
remain in salt water for a short time. Make a stuffing of the 
crumbs of light bread and add to it a little salt, pepper, butter and 
sweet herbs, and stir with a spoon. Then fill your fish with the 
stuffing and sew it up. Put on butter, salt, pepper and flour, hav- 
ing enough water in the dish to keep it from burning, and baste 
often. A four pound fish will bake in fifty or sixty minutes. 
355. Scrolled steaks. Sirloin and porter-house steaks 
should be broiled quickly. Preserve them on ice for a day or 
two and they are much tenderer. Never broil them, until the 
meal is ready to be served. 
356. Boiled Meat. When meat is to be boiled for 
eating, put it into boiling water, by which its juices are 
coagulated and its richness preserved. The slower it boils, the BEVERAGES. 
255 
tenderer, plumper and whiter it will be. Meat or poultry 
should be removed immediately after they are done, or they will 
lose their flavor and become soggy. 
357. Pork Steaks. The best steaks are cut off the 
shoulder — ham steaks being rather too dry. They should be 
well fried, in order to destroy the little living parasites called 
Trichinae which so often infest this kind of meat. They are in- 
troduced into the stomach by eating ham, pork, or sausages made 
from the flesh of hogs infested by this animal. Thorough cook- 
ing destroys them, and those who will persist in the use of 
swine’s flesh, can afford to have it done brown. 
358. Baked mutton. To bake mutton well, we should 
have a brisk, sharp fire and keep the meat well basted. It re- 
quires two hours to bake a mutton leg, weighing eight pounds. 
359. Bread. The enjoyment and health of a family de- 
pend, to a certain extent, on good, well baked bread. At all 
events, our enjoyment would be greater if it was only better 
prepared. We obtain the following extract from an article 
printed by the State Board of Health, concerning the food of the 
people of Massachusetts: “As an example of good bread we 
would mention that which is always to be had at the restaurant 
of Parker’s Hotel, in Boston. It is not better than is found on 
the continent of Europe, on all the great lines of travel, and in 
common use by millions of people in Germany and France; but 
with us, it is a rare example of what bread may be. It is made 
from a mixture of flour such as is generally sold in our markets, 
water, salt, and yeast — nothing else. The yeast is made from 
malt, potatoes and hops. The dough is kneaded from one and a 
half to two hours, and is then thoroughly baked.” The truth 
seems contained in this nutshell, that the kneading, which in 
this country takes the housewife’s time and muscle, in Europe 
is done by the help of machinery. So here, in large villages 
and cities, people may furnish themselves with good bread, by 
means of co-operative associations, even at a less cost than at 
present. 
BEVERAGES. 
360. Water. The importance of water in the economy of 
nature is obvious to all. It is the most abundant substance of COMMON SENSE MEDICAL ADVISER. 
which we have knowledge. It composes four-fifths the weight 
of the vegetable kingdom and three-fourths that of the animal. 
It is essential to the continuance of organic life. Water is uni- 
versally present in all of the tissues and fluids of the body. It is 
not oidy abundant in the blood and secretions, but it is also an 
ingredient of the solids of the body. According to the most 
accurate computations water is found to constitute from two- 
thirds to three-fourths the entire weight of the human body. 
The following table compiled by Robin Verdeil shows the 
proportion of water per thousand parts in different solids and 
fluids: 
QUANTITY OF WATER IN 1,000 PARTS. 
Teeth, . . . . 100 
Bones, .... 130 
Cartilage, . . . 550 
Muscles, . . . 750 
Ligaments, . . . 768 
Brain, .... 789 
Blood, .... 795 
Synovial fluid, . . 805 
Bile, .... 880 
Milk, . . . .887 
Pancreatic juice, . . 900 
Urine, .... 936 
Lymp, .... 960 
Gastric juice, . . . 975 
Perspiration, . . 986 
Saliva, .... 995 
361. The Natural Drink of Man. Water consti- 
tutes the natural drink of man. No other liquid can supply its 
place. It has been ascertained, by measuring the quantity of 
fluid taken with the drink, with the proportion existing in solid 
food, that for a healthy adult man the ordinary quantity of 
water consumed is a little more than four and one-half pounds 
per day. Its presence, however, in the body is not permanent. 
It is discharged from the body through four different agencies: 
(1.) The Urine; (2.) Feces; (3.) Breath; (4.) Perspiration. The 
first two are in a liquid, the remaining in a gaseous form. It is 
estimated that about forty-eight per cent, is discharged in the 
liquid and fifty-two per cent, in the gaseous form. Although 
the absolute as well as the relative amount discharged depends 
upon a variety of circumstances. 
362. Water is never found perfectly pure, since it holds in 
solution more or less of almost every substance with which it 
comes in contact. Rain falling in the country remote from 
habitations is the purest water that nature furnishes, for it is 
then only charged with the natural gases of the atmosphere. In MINERAL IMPURITIES. 
257 
cities it absorbs organic and gaseous impurities, as it falls through 
the air, and flowing over roofs of houses carries with it soot, 
dust, etc. Water from melted snow is purer than rain-water 
since it descends in a solid form, and is therefore incapable of 
absorbing gases. Rain-water is not adapted to drinking purposes, 
unless well filtered. All water except that which has been dis- 
tilled, contains air, and it is due to this fact, that aquatic animals 
can live in it; for example, put a fish in distilled water and it 
will soon die. 
363. Mineral Impurities. Rain-water which has 
filtered through the soil and strata of the earth, dissolves the 
soluble materials, and carries them down to lower levels until 
they finally collect in the sea. Common well, spring and mineral 
waters contain from 5 to 60 grs. to the gallon; sea water 2,600 
grs.; while in some parts of the Dead Sea there are 20,000 grs. 
to the gallon. The principal mineral impurities of well and 
spring water are lime, magnesia, soda and oxide of iron, com- 
bined with carbonic and sulphuric acids, forming carbonates, 
sulphates and common salt. The most general, however, are 
cai’bonate and sulphate of lime. 
Mineral waters are usually from springs which contain a con- 
siderable amount of saline matter. Those waters which abound 
in salts of iron are called chalybeate or ferruginous. Those 
containing salt are termed saline. Those in which the active 
ingredient is sulphur are termed sulphurous. Water derives 
its quality of “ hardness ” from the salts of lime — chiefly the 
sulphates — which it contains. “Hard water,” being an imper- 
fect solvent, is unsuitable for washing purposes. 
364. The purity of drinking water is a matter of much im- 
portance. That which contains a minute quantity of lead will 
give rise to all the symptoms of lead poisoning, if the use of it 
be sufficiently prolonged. An account is given, in a Dublin 
quarterly journal of Medical Science, of the ex-royal family of 
France, many of whom suffered from this cause at Claremont. 
The amount of lead was only one grain per gallon. Care should 
therefore be taken to avoid drinking the water which has stood 
in leaden pipes. It should always be allowed to run a few 
minutes before using. 
365. An excess of saline ingredients—which in small quantities 258 
COMMON SENSE MEDICAL ADVISER. 
are harmless — frequently produces marked disorders of the 
digestive organs. A small amount of putrescent matter habitu- 
ally introduced into the system, as in the use of food — is 
productive of the most serious results which can be traced to 
the direct action of the poison introduced. A case is recorded 
of a certain locality favorably situated with regard to the access 
of pure air, where an epidemic of fever broke out much to the 
astonishment of the inhabitants. Upon observation it was found 
that the attacks of fever were limited to those families who used 
the water of a neighboring well. The disagreeable taste of the 
water which had been observed, was subsequently traced to the 
bursting ,of a sewer, which had discharged a part of its contents 
into the well. When the cause was removed, there was no 
tendency to a recurrence of the effect. 
366. Organic Impurities. Water is liable to organic 
contamination from a multitude of causes, viz: drainages of 
dwellings, dust, insects, the decay of leaves, animals, etc. These 
impurities may be mechanically suspended or held in solution in 
the water. Although organic impurities, which are mechanically 
suspended in water, are poisonous, yet they are generally 
attended with animalcule, and these feed upon, and finally con- 
sume them. Good water never contains animalculse. They are 
never found in freshly fallen rain-water, remote from dwellings 
but abound, to a greater or less extent, in cisterns, marshes, 
ponds and rivers. These little workers subserve a useful end, 
since they consume the dead organic matter from the water, and 
having fulfilled their mission, sink to the bottom and die, leaving 
the water pure. Water which contains dissolved organic matter 
is exceedingly dangerous to health, and its use should be carefully 
avoided. 
367. In low lands where the current of streams is sluggish, 
and shallow pools abound, the water is apt to be more or less 
infected with decaying vegetable substances. Many people liv- 
ing in such localities, and wishing to obtain water with as little 
trouble as possible, dig a hole in the ground, of a few feet in 
depth, and allow the stagnant surface water to accumulate. 
This water is used for drinking and cooking. The result is that 
ague prevails in that locality. 
Care should be taken that wells, from which the water is used HOW TO USE WATER. 
259 
for household purposes, be removed from barn-yards, privies, 
sinks, vaults, etc. 
368. Purification Of Water. There are various 
methods of purifying water. It may be accomplished: (1.) By 
distillation, which is the most perfect method; (2.) By filtration 
through sand, crushed charcoal and other porous substances, it 
may be deprived of suspended impurities and living organisms; 
(3.) By boiling, which destroys the vitality of all animals and 
vegetables, drives out the gases and precipitates carbonate of 
lime, which composes the crust frequently seen upon the inside 
of tea-kettles or boilers; (4.) By the use of chemical agents, 
which may be employed to destroy or precipitate the offending 
substances. Alum is often used to cleanse roily water. Two 
or three grains in solution, being sufficient for a quart. It 
causes the impurities to settle to the bottom, so that the 
clear water can be poured or dipped off for use. One or two 
grains of the permanganate of potash will render wholesome a 
gallon of water containing animal impurities. Alkali, potash, 
etc., “soften” water by precipitating earthy salts. Water con- 
taining grs. of lime to the gallon is not suitable for laundry 
purposes. 
369. Slow to use Water. Very little if any water 
should he taken at meal time, since the salivary glands furnish 
an abundance of watery fluid to assist in mastication. "When 
these glands are aided with water to “ wash down ” the food, 
their functions become feeble and impaired. The gastric juice 
is diluted and digestion is weakened. Large draughts of cold 
water ought never to be indulged in, since they cause derange- 
ment of the stomach. When the body is overheated, much 
water is injurious. It should only be taken in small quantities. 
Thirst may be partially allayed—and without injury—by hold- 
ing cold water in the mouth for a short time and then spitting it 
out, taking care to swallow but very little. Travelers frequently 
experience inconvenience from change of water. If the means 
are at hand, let them purify their drinking water, if not, they 
should drink as little as possible. Persons who visit the banks 
of the Ohio, Missouri or Mississippi rivers and similar localties, 
almost invariably suffer from some form of stomachic or intesti- 
nal disease. Water standing in close rooms soon becomes unfit to 260 
COMMON SENSE MEDICAL ADVISER. 
drink and should not be used. A drink of cold water taken on 
retiring, and another on rising are conducive to health. “ Drink 
water,” said the celebrated Dubois to the young persons who 
consulted him, “drink water, I tell you! ” Du Moulin, the 
medical Dubois of his time, wrote, previous to his death, UI 
leave two great physicians behind me—diet and watery 
370. Tea and Coll'ee. These agents are almost uni- 
versally used as beverages, and when properly employed fulfill 
a four-fold purpose: (1.) They quench thirst; (2.) Excite an agree- 
able exhileration; (3.) Repress the waste of the system; and (4.) 
Supply nourishment. In consequence of being generally used at 
meal times, their stimulant properties are employed to promote 
digestion, and consequently they are not so objectionable as they 
might otherwise be. The liquids introduced into the stomach at 
meal times should not be cold. Tea and coffee are drank warm, 
while water, except in a few instances, is always drank cold, the 
effects of which have already been shown, (see 369). That 
their inordinate use may be injurious no one will deny, but this 
is equally true of other beverages, even simple cold water. 
Scientific investigators inform us, that these agents as beverages, 
judiciously employed, are not injurious. It has been urged that 
they are poisonous, but if they are, they are very slow in their 
operation. 
When properly prepared, they are very agreeable beverages, 
and as man will drink more or less at meals, they are allowable; 
for if their use was excluded, some other beverage would be 
sought after, and quite likely one of an alcoholic character 
accepted; so of two evils, if this be an evil, let us choose the 
least. Unlike alcoholic stimulants, they exhilerate and gladden, 
without a depressing reaction after their influence has passed off. 
They “ cheer, but do not inebriate.” But one cup should be 
drank at a meal, and it should be of moderate strength. The 
use of large quantities of strong tea or coffee stimulates the 
brain to wakefulness, and produces irritability of the nervous 
system. When they are productive of such effects, they are 
injurious, and should be considerably moderated or wholly dis- 
continued. No criterion can be given by which the amount the 
system will tolerate can be regulated. What one will take with 
impunity, will be deleterious to an other. Individuals differ MALTED BEVERAGES. 
261 
greatly in this respect. There are some who cannot tolerate 
them at all, either because of some peculiarity of constitution, 
or the existence of disease. And sometimes when tea is agree- 
able and beneficial, coffee will disagree—and vice versa. Persons 
of nervous habits, either natural or acquired, will be apt to find 
their wakefulness and irritability increased by the use of tea, 
particularly if strong, while coffee will prove a “ balm in Gilead.” 
On the other hand, persons of a lymphatic or bilious disposition, 
will often find coffee to disagree with them, aggravating their 
troubles and causing “biliousness,” constipation and headache, 
while tea will prove agreeable and beneficial. Whenever they 
disagree wfith the system the best rule is to abandon their use. 
We find many persons who do not use either, and enjoy health, a 
fact which proves that they are not by any means indispensable, 
and no doubt, were it customary to go without them, their 
absence would be but slightly missed. 
371. They are adulterated to a very great extent, and persons 
using them will be frequently imposed upon. This is an evil we 
cannot remedy. If people make use of them, their experience 
in selecting them must be their guide; however, it is believed, 
that the Black or Japan varieties of tea are the least apt to be 
adulterated, and coffee, to insure purity, must be purchased in 
the berry, and ground by the purchaser. 
372. To prepare tea an infusion should be made by adding 
boiling water to the leaves, and permitting it to steep for a few 
minutes only, as a concentrated decoction, made by boiling for a 
long time, liberates the astringent and bitter principles and 
drives off the agreeable aroma which resides in a volatile oil. 
Coffee should be prepared by adding cold water to the ground 
berry, and raising it slowly to the boiling point. Long contin- 
ued boiling liberates the astringent and bitter principles upon 
which its stimulant effects to a great extent depend, and drives 
off with the steam the aromatic oil from which the agreeable 
taste is derived. 
373. Malted Beverages. Under this head are in- 
cluded all those beverages into the composition of which malt 
enters ; as, Ale, Beer, Porter, Lager, etc. 
Properties.—They possess, according to Pereira, three prop- 
erties : (1.) They quench thirst ; (2.) They stimulate, cheer, 262 
COMMON SENSE MEDICAL ADVISER. 
and if taken in sufficient quantity, intoxicate ; and, (3.) Nourish 
or strengthen. The first of these qualities is due to the water 
entering into their composition ; the second, to the alcohol ; the 
third, must be attributed to the nutritive principles of the barley 
from which the malt is prepared. The elements of nutrition, 
however, entering into their composition, are very limited, and 
we fully believe that the same amount of capital, invested in 
nourishment of a different character, would yield far greater 
results. A mere stimulation of the nervous system, is apt to be 
mistaken for a genuine increase of strength, such as only good 
wholesome food produces. Hence, we see how very liable we 
are to overestimate the virtue of these beverages, as sources of 
nutrition. According to Leibig, “ good beer imparts a sense of 
warmth and stimulation not obtained from bread and meat.” A 
tea-spoonful of alcohol in a tumbler of water would produce the 
same result. It would yield more warmth and stimulation than 
bread and meat, and yet no one would think that it would build 
up the system, and repair its waste, like those substantial articles 
of food. In fact, it would contain no nutrition whatever. 
374. Objections to their use as Beverages. 
We notice, first, that these articles are either pure or adulterated. 
In their pure state the objection to their use for this purpose lies 
in the fact that they contain alcohol. This is a poisonous sub- 
stance, which the human system in a state of health does not need. 
Its use, when the body is in a normal condition, is uncalled for, 
and can only be deleterious. In such a case it enters into the 
system as a disturbing force. Exciting the machinery of life 
to more rapid action, it causes a breakdown at an earlier period 
than if the use of it be altogether dispensed with. Scientific 
experiments prove that alcohol never assimilates with the system. 
It never becomes transformed into nerve, bone, or muscle, as is 
the case with ordinary food. Owing to its penetrating character 
it permeates the entire body, but wherever found, in the brain, 
the blood, or other fluids of the system, it is alcohol still. When 
expelled from the body, whether through the pores of the skin 
or the excretory canals, it is yet alcohol—nothing more nor less. 
Beverages containing this poison are more or less deleterious to 
healthy persons, according to the amount of it that enters into a 
given quantity. FERMENTED BEVERAGES. 
263 
We observe, in the second place, that these liquors are exten- 
sively adulterated, and this increases their injurious effects. 
The ingenuity of man has been taxed to increase their intoxi- 
cating properties, and still retain their names. To effect this, 
narcotic and stimulating drugs have been employed. Those 
used for this purpose are the Coculus Indicus, Poppy, Opium, 
St. Ignatius Bean, Henbane, etc. The pungent taste is aug- 
mented by using Grains of Paradise or Cayenne Pepper. The 
bitter which is supposed to be derived from hops is often supplied 
by Aloes, Quasia, Gentian, Wormwood, etc. Soap-suds make a 
very good menstruum in which to mix them. As age imparts a 
desirable quality, a two year old barrel of beer is often made in 
a few minutes by adding a little sulphuric acid. Would it not 
contribute very much toward the abandonment of these articles 
as beverages, if those wTho use them as such, would but stop a 
moment and consider the impositions practiced, upon them? 
The use of such stimulants unduly excite the brain, and are 
followed by exhaustion, which, in its turn, pleads for a repetition 
of the stimulant. 
This leads us to speak of our third and last objection to the 
use of these compounds as beverages. Their manifest tendency 
is to create an appetite for stronger stimulants, and thus lay the 
foundation for inebriation. The disposition of man is to go to 
extremes, and he continually seeks for authority to sanction his 
acts. Knowing this, we can but take our present position on 
this subject. We decline to lend our sanction to any practice 
that is liable to make men drunkards. 
375. Fermented Beverages. These are. Cider, 
Wine, etc. It is true that beer, and all drinks of its class, are 
fermented ; but they are prepared from malt, while cider and 
wine are not. We therefore class them as fermented beverages, 
to distinguish them from the foregoing. They,contain a larger 
percentage of alcohol than malt liquors. This is especially 
true of wine. Cider will usually be found to contain about one 
per cent, more alcohol than lager beer. Wine, owing to the 
greater amount of sugar contained in it before fermentation, 
contains a much larger per cent, of alcohol after this process is 
completed. As beverages, these are open to the same objections 
as those manufactured from malt. As a medicine, wine is a 264 
COMMON SENSE MEDICAL ADVISEE. 
useful remedy. Concerning its use in this capacity, Prof. Leibig 
says : “ Wine is a restorative. As a means of refreshment 
when the powers of life are exhausted—as a means of compen- 
sation where a misappropriation occurs in nutrition, and as a 
means of protection against transient organic disturbances, it is 
surpassed by no product of nature or art.” That an article is 
useful in medicine, however, is no reason why it should be used 
as a beverage by those in health. It is rather an argument 
against such a practice. For it is generally true that the drugs 
used to restore the ailing system to health, are pernicious oi 
poisonous to it when in a normal condition. 
376. Distilled Liquors. These are Whisky, Brandy, 
and kindred productions of the still. Of their habitual use we 
can do no better than to quote Leibig again. He says : “ He 
who drinks them draws a bill, so to speak, on his health. This 
bill must always be renewed, because he cannot, for want of 
means, take it up. He consumes his capital instead of his 
interest, and the result is bankruptcy of his body.” 
THE CLOTHING. 
377. There is no physical agent which exerts a more constant 
or powerful influence upon health and life, than the atmosphere. 
The climate in these latitudes is exceedingly variable, ranging 
all the way from 90° F. in summer to 20° beloiv zero in the 
winter season. Every individual requires that his body be so 
protected from cold, that it can maintain a mean temperature of 
97° F. This presupposes that it possesses some heat-generating 
process' within, to assist in keeping it evenly warmed. 
378. It is a fact also, that when the body is warm there is 
a free and equal circulation of the blood throughout all the 
structures. When the surface is subjected to cold, the myriad 
of capillaries and minute vessels, carrying the blood, contract 
and diminish in their size, throwing this fluid upon the internal 
organs, thus causing congestion. The blood must go somewhere, 
and if driven from the surface, retreats to the cavities within. 
Hence, this repletion of the vital organs causes pain from pres- 
sure and fullness of the distended blood-vessels, and the organic 
functions are embarrassed. Besides, cold upon the surface shuts 
up the pores of the skin, which are the most active and important CLOTHING. 
265 
emunctories of the system. It is evident, then, that we require 
suitable clothing, not only for comfort, but to maintain the 
temperatui-e and functions essential to health and life. 
379. Now, what are the best materials for clothing the 
body? The chief object to be attained by dress is the main- 
tenance of a uniform temperature of the body. To attain this 
end, it is necessary that the exhalations of the system, which ai-e 
continually escaping through the pores of the skin, should be 
absoi-bed or conducted away fi-om the person. These exudations 
occur in the foi-m of sensible or insensible perspiration, and the 
clothing, to be healthy, should be so porous as to allow them 
freely to escape into the air. 
A substance should also be chosen which is known to be a 
poor conductor of heat. That generated by the system will thus 
be retained where it is needed, instead of being dispersed into 
the atmosphere. 
We might add that the better the material for accomplishing 
these purposes, the less will be needed to be worn; for we do not 
wish to wear or carry about with us any moi*e material than is 
necessary. It so happens that all of these qualities are found 
combined in one material, viz : flannel. The value of this article 
worn next to the skin cannot be overrated, for while it affords 
protection from cold during the winter months, it is equally 
beneficial during the heat of summer, because it imbibes the 
perspiration, and being very porous allows it to escape. The 
skin always feels soft, smooth, and pliable, when it is worn ; but 
when cotton takes its place, it soon becomes dry and harsh. Its 
natural adaptability to these purposes, shows that it is equally 
a comfort and a source of health. Where the skin is very 
delicate, flannel sometimes causes irritation. In such cases a 
thin fabric of linen, cotton, or silk, should be worn next the 
skin, with flannel immediately over it. Where there is a 
uniform and extreme degree of heat, cotton and linen are very 
conducive to comfort. But they are unsuitable in a climate ox- 
season liable to sudden fluctuations in tempei-ature. 
The value of furs, where people are exposed to extreme cold, 
cannot be overestimated. They are much warmer than wool, 
and are chiefly used as wraps on going outdoors. They are too 
cumbrous and expensive for ordinary wear in this latitude, but 266 
COMMON SENSE MEDICAL ADVISER. 
in places nearer the poles they constitute the chief clothing of 
the inhabitants. 
380. The quantity of clothing worn is another important 
item. The least that is necessary to keep the body well pro- 
tected and evenly tempered w'hen employed is the rule of 
health. Some people, instead of wearing flannels next to the 
body, put on other material in greater abundance, thus confining 
the perspiration to the skin and making the body chilly. The 
amount of clothing is then increased, until they are so thoroughly 
bundled that they cannot exercise. We knew of one lady who 
was literally wound in thirty thicknesses of common cotton 
cloth, and she was not warm either ! Far better to wear one 
thickness of flannel next to the skin, and then cotton, or woolen 
for outside garments, and be able to exercise, thus allowing the 
blood to circulate and to assist in the warming process. 
381. One great fault in dress consists in neglecting to prop- 
erly clothe the upper and lower extremities. Some people do 
not reflect upon the necessity, while others are too proud to be 
directed by plain common sense. In the winter season, the feet 
should be covered with woolen stockings. The next matter of 
importance, is to get a thick, broad-soled shoe, so large that it 
will not prevent the free circulation of the blood. Then for 
walking, and especially for riding, when the earth is wet and 
cold, or when there is snow on the ground, wear a flannel- 
lined rubber, or Arctic over-shoe. lie sure and keep the feet 
comfortable and warm at all times. 
382. Our next advice is, keep the legs warm. Somehow, 
legs are more fashionable than popular, and hence, though they 
are indispensable agents, we hardly ever allude to them. They 
are deserving the best of care, and should be kept warm and 
comfortable. We were called, not long ago, to see a young 
lady who had contracted a severe cold. She had been to a party 
where the apartments were nicely warmed, and had greatly 
enjoyed the social occasion, and from thence had walked home 
late in the evening. Of course, we inquired, as well as we 
knew how, into the circumstances of the case, and ascertained 
that she wore flannel about her chest, and that she also wore 
rubbers over her shoes. But the other portions of the lower 
extremities were protected only by cotton coverings! In short, CLOTHING. 
267 
her legs were not kept warm, and she took cold by coming out 
from those nice, warm rooms into a raw, chilly atmosphere. A 
good pair of woolen leggins might have saved her many pains. 
383. What are the results of insufficient protection of the 
lower extremities, if not colds, coughs, consumption, headaches, 
pain in the side, menstrual derangements, uterine congestions 
and disorders, chronic sickness, doctoi’’s bills, besides being dis- 
abled for the ordinary and necessary duties of life ? All this 
may be pi*evented by hygienic attention to clothing the legs 
suitably, and wearing comfox-table flannel. It is the dictate of 
prudence and common sense to keep warm and healthy, and 
personal neglect shows a lack of both commodities. 
384. Young people can bear a low temperature of the body 
better than old people, simply because they possess greater 
power of endurance. But that is no reason for running into 
peril, and laying aside good sense. 
385. The amount of clothing ought to be graduated accord- 
ing to the heat-generating power of the individual, and also 
according to his susceptibility to cold. No two persons are 
alike in these respects. But it is never suitable for young 
persons to reject the counsels of experience, or treat lightly the 
advice to protect themselves thoroughly against the cold. 
Many a parent’s heart has ached as he has followed the earthly 
remains of a darling child to the grave, knowing that if good 
advice had been heeded, in all human probability, the life might 
have been lengthened, and filled with usefulness. 
386. Young misses, who imprudently bare their arms, wear 
low dresses and expose the neck and chest to cold, ai'e the same 
butterflies of fashion after marriage. How do they treat the 
darling baby ? The same vanity is aroused, and they must 
make a constant exhibition of baby graces, expose its plump, 
white, fat chest, arms and legs, di’ess it in the latest, half-clad 
style, to excite the envy of other mothers. Suddenly the 
mercury drops, the temperature falls and baby is forgotten 
almost, until its cries of pain call the mother’s attention, and its 
continual writhings show that inflammation is already fastening 
upon it. The doctor is sent foi', but his skill is a very poor 
substitute for that care and attention—born of good common 
sense—which might have averted all this illness. 268 
COMMON SENSE MEDICAL ADVISER. 
387. When it becomes fashionable to be healthy, then we 
will follow the style. But so long as dress-makers display such 
vulgarity in padding the chest and making artificial bosoms, and 
compressing the waists of girls until they are caricatures of 
feminine grace, monstrosities in the flower garden of humanity, 
it is the duty of sensible mothers to protest. Where is there 
any room for stomach, liver, bowels, or any such vulgar things, 
when dresses are nicely, snugly fitted to delicate and yielding 
waists? Yet Fashion continues to pinch the body, and the 
result is congestion, displacement and prolapse of these organs. 
The tastes of our fashionable modistes need to be cultivated by 
a due regard for Hygiene and Physiology, and then they may 
follow the rules of art in dress, and direct public sentiment in 
healthy channels, and be not only ornamental but highly useful 
members of society. At present they are only beneficial to 
society, as it would appear, in killing off silly women who disre- 
gard the conditions of health and usefulness. Under the present 
dispensation of Fashion, the doctrine of “ the survival of the 
fittest,” is fully exemplified. 
388. Clothing ought never to he worn snugly, especially by 
children and girls, whose bones are soft and yielding, nor should 
its weight be suspended from the hips, but rather from the 
shoulders. The diminution of the waist, the compression of the 
ribs, the displacement of the vital organs prohibiting the natural 
expansion of the lungs, are all alike destructive to beauty and 
health. The aesthetic ideas of the Greeks were not thus per- 
verted, for wherever we find an image of the Grecian form, it is 
true to nature, and therefore a model of beauty. The Venus 
de Medici has for ages been the admiration of the world, since 
it is a representation of the true female form. Not less perfect 
are the outlines of the Greek Slave, (see Fig. 100). It is a false 
notion that symmetry resides in a wasp-like waist. Beauty and 
health are inseparable, the former being a symbol of the latter. 
There is nothing more noble, majestic, or exquisitely aesthetic, 
than the perfectly developed human form. A full development 
of the chest and lungs is necessary to the inspiration of an 
adequate quantity of pure air, which is essential to mental and 
physical vivacity. Contracted chests — small lungs — tend to 
make feeble, dispirited women, without vigor and resolution, and CLOTHING. 
269 
subject to pulmonary disease. On the other hand, we associate 
strength, resolution, physical hardihood, and all the warm, gen- 
erous impulses, with persons possessing natural waists, for such 
suggest cheerfulness, goodness, capability, as well as womanly 
grace and dignity. CHAPTER III. 
PSEUDO-HYGIENE. 
389. There are quacks in Hygiene as well as in Medicine, 
and hence, Hygiene itself is pre-judged by its bad associations. 
As when, in any neighborhood or society, some person is charged 
with being the chief sinner, and made the scape-goat for the rest, 
so, in the human system, doctors hunt for the chief offender and 
load him with the guilt of all. Allopathic physicians seem to con- 
sider the liver as the great sinner; Hydropathists think the skin 
is the principal criminal; Botanic doctors find the vascular 
system the delinquent; while Pseudo-IIygienists regard the 
stomach as the villain. Impute a bad character to a good man, 
and it is exceedingly demoralizing. Ho matter how faultless 
one is, slander always tarnishes his reputation. And so, modern 
Pseudo-IIygienists treat the stomach as though it were a villain, 
and the stomach responds like a reprobate. Believing and acting 
\ipon the assumption that the stomach is bad, deranges its func- 
tions, which, in turn, perverts the judgment. Modern Hygienists 
cry out, “There are two millions of dyspeptic stomachs in 
America,” and five millions of stomachs respond with newly 
begotten illusory sensations. 
390. “ Two meals a day,” is the cure-all, because they claim 
that three meals are decidedly injurious to health. It is quite 
fashionable, in certain quarters, to recommend the accused dys- 
peptic to eat all that he requires- for twenty-four hours at two 
meals, assigning as the reason, that it gives more time for the 
stomach to rest, after the wearying efforts of digestion. Is this 
a good reason, or only a fallacy ? What does common obser- 
vation disclose concerning those who follow this advice? Sojourn PSEUDO-HYGIENE. 
271 
for one week in any institution practicing the two meal system, 
and witness the consequences. If “chewing the string is testing 
the pudding,” then the evidence is conclusive that the attempt to 
carry out this theory, is miserable gluttony and worse dyspepsia ! 
391. They violate the rules of health by taking too large 
quantities of food. It is astonishing how hungry people become 
after twelve hours abstinence, and what amazing quantities they 
will devour, under the specious idea that they are practicing 
pure Hygiene ! They eat as though they were inspired with 
this injunction, “ Eat enough at two meals to last all day.” 
Indeed, some argue in favor of quantity, as though bulk was a 
salubrious item in the reform. If it is only vegetable food, that 
is the main point, irx*espective of the amount consumed. 
392. They would not he flesh-eaters ; no, indeed ! meat is 
too stimulating, even vulgar,—tending to excite the animal 
nature. Two meals in which they gorge their stomachs with 
coarse bread, potatoes, baked apples, boiled rice, cracked wheat 
and syrup, concluding with a few raw apples for dessert, consti- 
tute their daily routine of gormandizing. We would not wish 
to be understood as condemning the articles that make up the 
limited bill of fare of these fanatics, for, so far as they go, they 
are generally very good ; but what we object to is, the absurd 
practice of excluding other edibles, equally valuable, by which 
the system is denied many of the elements necessary for its 
healthful nourishment. We also protest against the irrational 
practice of abstaining from food until ravenous hunger can be 
satisfied only by indulging the appetite to excess. Is it any 
wonder that such Hygienists are dyspeptic gluttons ? Do not 
their very teachings and perverted ideas of Hygiene, lead them 
in the way of becoming the worst gormandizers that disgrace 
civilization ? Their everlasting threadbare theme is, bad cookery 
and the poisonous qualities of detestable butter and lard. They 
vent their spleen against every thing “ short.” It is even con- 
sidered polite in them to ask, “ Is salt in this ? ” or, “ Butter in 
that?” “Is shortening in this?” or “seasoning” in the other 
article before them. If they do not ask, “ How is this prepara- 
tion made?” they will ask if it is “injurious to health.” Then 
they condescend to give a careful and interesting (ugh!) detail 
of what agi’ees with their stomach, and what does not; and 272 
COMMON SENSE MEDICAL ADVISEE. 
should you happen to be indiscreet enough to express a differing 
opinion, you will experience the pleasure of a well planned and 
masterly executed attack, backed by a terrible array of whims, 
conceits and prejudices. Meantime they will inspect some plain 
article of food, turn it over suspiciously, and finally smell of and 
taste it, perplexed whether to eat it or let it alone. Evidently 
there is a fearful struggle going on between perverted ideas,- a 
morbid appetite and good breeding! “ They are sick, that 
surfeit with too much, as they that starve at nothing,” and so 
they fluctuate between extremes. They seem to think that gas- 
tric topics are always in good taste. They abjure butter, pastry, 
coffee, tea, meats, and superfine flour, but just set before them 
mush, apple sauce, milk and Graham crackers, and all scruples 
suddenly scatter, while the food as quickly disappears. Don’t 
ask us what becomes of these rations. Byron says, “ Besides, 
they always smell of bread and butter,” but we think if he had 
been entertained by these modern Hygienists, he would have 
said, “ of mush and apple sauce.” 
393. The distinguishing trait of this class of Hygienists is, 
that they will persist in overloading the stomach. No poor 
donkey bears a heavier load than this overburdened organ. It 
is fearfully gorged until its muscular fibres are weakened by the 
extreme distention, and thus disqualified to churn the food. 
Show them this fact, and it is all Greek to them. Reason with 
them that it is far preferable to eat three spare meals a day, of 
such food as easily and quickly digests without causing pain or 
languor, and they don’t comprehend. They remind us of the 
couplet: 
“ The fool of Nature stood with stupid eyes, 
And gaping mouth, that testified surprise.” 
We have wondered if, when Dry den wrote those lines, he had 
not discovered some of the progenitors of this particular class. 
Some of these modern, self-dubbed Hygienic Professors, seem to 
act as though gormandizing was a virtue, if only restricted to 
the use of coarse food and vegetables. They are an unhappy 
race of grumblers and fault-finders. Who ever knew of one 
who was satisfied, even when surfeited ! They grunt, belch, 
and complain, a burden to themselves, and common nuisances 
everywhere. When away from the table, they cannot open their PSEUDO-HYGIENE. 
moutlis without reciting their woes and bewailing their discom- 
fort. From headaches, sour stomachs, water-brash, blues, nausea, 
retching, and Pseudo-Hygienists, “ Good Lord deliver us.” Tell 
a dyspeptic disciple of this school, for the ninety-ninth time, to 
stop overloading his stomach, and though he promises amend- 
ment, yet at the very next meal he proves recreant to his pledge. 
It is worth more to cure such of their theoretical delusions, than 
to direct them in the way of abstinence. We have seen such 
rub and work over the stomach a half-hour at a time, to 
help it mix up and digest the food! Such need to learn the 
simplest rules of self-control, and then any experienced nurse, a 
good old lady, for example, to be found in any neighborhood, 
can direct them in better habits, and instruct them in those 
practical matters which lead to health and usefulness. CHAPTER IV. 
PHYSICAL CULTURE. MEN- 
TAL CULTURE. SLEEP. 
CLEANLINESS. 
394. A well developed physical organization is the primary 
condition of health. Among the Grecians, beauty ranked next 
to virtue, and an eminent author has said that “ the nearer we 
approach Divinity, the more we reflect His eternal beauty.” 
The expression of thought requires the physical accompaniments 
of language, gesture, etc. The human form is pliable, and with 
appropriate culture, can be made full of expression, grace and 
beauty. The cultivation of the intellectual powers has been 
allowed to supplant physical training to a great extent. The 
results are abnormally developed brains, faces d la spirituelle, 
delicate forms, sensitive nerves and short lives. That the vital 
and mental systems should be collaterally developed, is a fact 
generally overlooked by educators. A refined intellect cannot 
find its appropriate expression in a frail, uncultivated body. We 
have sought perfection in animals and plants. To the former we 
have given all the degree of strength and grace requisite to 
their peculiar duties ; to the latter we have impaired all the 
delicate tints and shadings that fancy could picture. We have 
studied the laws of their existence, until we are familiar with 
every phase of their production : yet it remains for man to learn 
those laws of his own being, by a knowledge of'which he may 
promote and preserve the beauty of the human form, and thus 
render it, indeed, an image of its Maker. When the body is 
tenanted by a cultivated intellect, the result is a unity which is 
unique, commanding the respect of humanity, and insuring a PHYSICAL CULTURE. 
275 
successful life to the possessor. “You’re a splendid animal,” 
said Fowler to Henry Ward Beecher. “That’s just it: that’s 
the secret of my success,” was the response. Clergymen and 
students are proverbially pale and emaciated. Mental concen- 
tration is generally the assigned cause, when in reality it is the 
result of insufficient exercise, impure air and dietetic errors. An 
intelligent journalist has remarked that “many of our ministers 
weigh too little in the pulpit, because they weigh too little on 
the scales.” The Grecian Gymnasium and Olympian Games 
were the sure foundations of that integral education from which 
arose that subtle philosophy, poetry and military skill, that have 
won the admiration of nineteen generations. The simple leafy 
crown of the Olympian victor was far more precious to the 
Grecian youth than the gilded prize to our modern genius. A 
popular lecturer has truly remarked, that ‘' we make brilliant 
mathematicians and miserable dyspeptics ; fine linguists with 
bronchial throats ; good writers with narrow chests and pale 
complexions; smart scholars, but not that union, which the 
ancients prized, of a sound mind in a sound body. The brain 
becomes the chief working muscle of the system. We refine 
and re-refine the intellectual powers down to a diamond point 
and brilliancy, as if they were the sole or reigning faculties, 
and we had not a physical nature binding us to earth, and a 
spiritual nature binding us to the great heavens and the greater 
God wTho inhabits them. Thus the university becomes a sort of 
splendid hospital, with this difference, that the hospital cures, 
while the university creates disease. Most of them are indicted 
at the bar of public opinion for taking the finest young brain 
and blood of the country, and, after working upon them for four 
years, returning them to their homes skilled indeed to perform 
certain linguistic and mathematical dexterities, but very much 
below par in health and endurance, and, in short, seriously 
damaged and physically demoralized.” We read with reverence 
the sublime teachings of Aristotle and Plato ; we mark the 
grandeur of Homer and the delicate beauties of Virgil; but we 
do not seek to reproduce in our modern institutions the gymna- 
sium, which was the real foundation of their genius. Colleges 
which are now entering upon their career, should make ample 
provision for those exercises that develop the physical man. 276 
COMMON SENSE MEDICAL ADVISEE, 
America needs a Yale and West Point combined. This lack, of 
bodily training is habitual with all classes, and its effects are 
written in indellible characters on the faces and forms of old and 
young. Malpositions in sitting restrict the movements of the 
diaphragm and ribs, and cause those diseases of the spine, or 
unnatural curvatures, which prove so disastrous to health and 
happiness. The head should be erect and the shoulders thrown 
backward, so that at each inspiration the lungs may be fully 
expanded. 
395. An Erect Carriage, is not only essential to 
health, but lends grace and beauty to each movement. Although 
man was made to stand erect, thus indicating his supe- 
riority over all other animals, yet custom has done 
much to curve that magnificent central column, upon 
the summit of which rests the “grand dome of 
thought.” Many young persons, unconsciously acquire 
the habit of throwing the shoulders forward. The 
spinal column is weakened by this unnatural posture, 
its vertebrae become so sensitive and distorted, that 
they cannot easily support the weight of the body or 
sustain its equilibrium. It is generally believed that 
persons of sedentaiy habits are more liable to become 
“ round shouldered ” than any other class of individ- 
uals. Observation shows, on the contrary, that the 
manual laborer, or even the idler, often acquires this 
stooping posture. It can be remedied, not by artificial 
braces, but by habitually throwing the shoulders back- 
wards. Deformed trunks and crooked spines, although some- 
times the effects of disease, are oftener the legitimate results 
of carelessness. Jaques has remarked that “one’s standing 
among his fellow men is quite as important a matter in a physio- 
logical., as in a social sense.” Walking is one of the most 
efficient means of physical culture, as it calls all the muscles 
into action and produces the amount of tension requisite for 
their tonicity. The first essential to a healthful walk is a 
pleasurable object. Beautiful scenery, rambles in meadows rich 
with fragrant grasses, or along the flowery banks of water 
courses, afford agreeable stimuli which send the blood through 
the vital channels with unwonted vehemence and impart to the 
Fig. 108. SKATING AND ROWING. 
277 
cheeks the rich bloom of health. Our poets acknowledge the 
silent influence of nature. Wordsworth, the lake poet, has 
expressed this thought in his own chaste style: 
“ The floating clouds their state shall lend 
To her: for her the willow bend; 
Nor shall she fail to see, 
E’en in the motions of the storm 
Grace that shall mould the maiden’s form 
By silent sympathy. 
The stars of midnight shall be dear 
To her: and she shall lean her ear 
In many a secret place, 
Where rivulets dance their wayward round, 
And beauty, born of murmuring sound, 
Shall pass into her face.” 
396. liunilillg is a fine exercise for children and robust 
men, but should be indulged in moderately. The peculiar con- 
dition of woman unfits her for violent movements. Some author 
maliciously observes, that “ women run merely in order to be 
caught.” We have modem Atalantas, yet the majority of our 
women are too weak, listless or indifferent to even walk rapidly. 
Restrictions have fettered the feet of our girls, many of whom, 
if untrammeled by fashion and their mammas, would be as fleet 
of foot as their brothers. If you hear them say, “ She’s a little 
romp,” depend upon it, “ she ” is a bright, energetic girl, who 
will follow the footsteps of Ilygeia wherever she may lead — in 
the fields, through the brooks, over the fences or on the highest 
limbs of the old apple tree—and when she returns from the race, 
mark the joyous laugh and the bright glow of health. When 
nature moulds her form into the delicate outlines of womanhood, 
she can no longer vie with her brothers in fleetness, and other 
exercises must replace the violent amusements of childhood. 
Running is unwomanly only so far as it is unhealtliful. 
397. SStating and Mowing' are exercises that develop 
the muscles of the arms and limbs. The former should not be 
too prolonged and the clothing should be warm and appropriate. 
College regattas are rapidly becoming more popular, notwith- 
standing many severe criticisms from the press. As an exercise 
for the health and development of our students it should be 278 
COMMON SENSE MEDICAL ADVISER. 
universally recommended. It expands the lungs and strenghtens 
the muscles of the arms and chest. Every college should he 
located near some inland lake or river, and a boat-house erected 
and provided with the necessary equipments. Amusements are 
just as essential to the student as a library or a laboratory. 
398. Tlae Art Of Swimming was regarded by the 
Athenians as an im- 
portant accomplish- 
ment of the Grecian 
youth. We have our 
modern Ilellesponts, 
but no Leander or 
Byron. As a hygienic 
agency it occupies a 
high rank in physical 
culture. The free and 
graceful movements 
impart strength and elasticity to the muscles, and the magnetic 
virtue of the limpid waves invigorates the body, while the con- 
quest of a new element inspires the whole being with a sense of 
triumphant power. It is a charming recreation for our wives 
and daughters. Again, it is not only a means of physical cul- 
Fig. 109. 
Fig. 110. 
ture, biit often essential to self-preservation. Figs. 109 and 
110 represent the consecutive positions assumed by an expert 
swimmer. 
399. IS a sc Ball, Cricket, Boxing and Fenc- 
ing, are all manly games when practiced only with a view 
to their hygienic advantages, and as such have our heartiest 
approval. 
400. Hiding on Horseback is a fine exercise for 
both sexes. It promotes digestion, increases the circulation and 
expands and develops the respiratory organs. The pure, fresh 
air, pleasant prospects, and pleasurable excitement impart EXERCISES OF THE GYMXASIUM. 
renewed vigor to the morning equestrian. In the Southern 
States it is a universal accomplishment, and chil- 
dren are taught to ride as well as to walk. In the 
highlands of honnie Scotland, the chase is a favorite 
pastime, and Scottish lads, mounted on their swift 
coursers, span crag and fell with a celerity that 
would i;ender the American youth breathless. And 
no people are more remarkable for health and 
handsomely developed forms, than our highland 
friends. 
401. Dancing. “Dancing is an invention 
of the devil,” is the verdict of learned and dignified 
synods: and as it is usually conducted, it must be 
confessed that their disapproval is well founded. 
The clergy, as a class, are not a set of ascetics, 
nor are they inclined to condemn any practice unless 
they see in it tendencies pernicious to society. 
The fashionable, promiscuous ball, protracted far into night, 
or even till the dawn of morning, in a heated atmosphere, and to 
the sound of voluptuous music, is injurious both to health and 
morals. It merits all the condemnation it has ever received. 
It seems impossible to exclude from these gatherings men who 
are unchaste in thought and impure in life. And how can we 
consent to have our virtuous sisters or daughters subjected to 
the delicate and skillful manipulations of those whose touch, 
whose very look even, is charged with a magnetic influence that 
excites unhallowed desires, and “ sets on fire the courses of 
nature ” ? But notwithstanding the fact that the dance has 
been perverted to the basest purposes—been made the fruitful 
source of dissipation, and has often laid the foundation for 
disease, it is still capable of being made to minister to health 
and happiness. As a means of physical culture, it favors the 
development of the muscular system, and is promotive of health 
and cheerfulness. When practiced for this purpose, Jacques 
terms it “ the best of all indoor exercises, as it brings to bear 
upon the physical system a great number of energizing and 
harmonious influences.” 
Fig. 111. 
402. The Exercises of the Crymnasium are es- 
pecially productive of health and longevity. The most important 280 
COMMON SENSE MEDICAL ADVISER. 
of these are, balancing, leaping, climbing, wrestling and throwing, 
all of which are especially 
adapted to the develop- 
ment of the muscles. In 
conclusion, we offer the 
following suggestions, viz: 
(1.) All gymnastic exer- 
cises should be practiced 
in the morning, and in the 
open air; (2.) Extremes 
should be avoided ; and, 
(3.) It must always be 
borne in mind, that their 
chief object is to combine, 
in a proper proportion, 
mental and physical de- 
velopment. In every re 
lation of life we should cultivate all those faculties which 
pertain to our physical, moral and mental natures, subdue our 
passions, and nature will bestow her richest rewards of health, 
beauty, and happiness. 
Fig. 112. 
The Gymnast’s Arm. 
MENTAL CULTURE. 
403. The brain, like all other organs of the body, requires 
alternate exercise and repose ; and, in physical endurance, it is 
subject to general physiological laws. When exercised with 
moderation it acquires strength, vigor, and an accelerated 
activity. Excessive mental exertion is liable to result in soften- 
ing of the brain, and various nervous diseases, sometimes 
culminating in insanity, and in many instances proving fatal to 
life. The mere votaries of pleasure who discard all effort of the 
mind, fall into the opposite error. In all cases of intellectual 
activity, the exertions should be directed to some subject inter- 
esting to the student. In this manner duty will become a 
pleasure, which in turn will reinvigorate the mental functions. 
404. When the mind is confined to one subject for any con- 
siderable length of time together, it becomes fatigued, and 
requires relaxation, recreation, rest. This may be obtained by 
directing the attention to some other subject, either study or MENTAL CULT CUE IN CHILDHOOD. 
281 
amusement, the latter of which is preferable. The amusement, 
however, may be of an intellectual or physical character, or both 
combined, and will, if properly conducted, restore energy and 
vigor, to both mind and body. 
405. Prominent among physical phenomena is the mutual 
relation between the brain and the organs of nutrition. Mental 
exertion should be avoided for at least one hour after a hearty 
meal,and all mental labor which requires concentration of thought 
ought to be accomplished in the earlier portion of the day, when 
the brain is refreshed and repaired by the night’s repose. The 
“ midnight oil ” and emaciated, dyspeptical literati, are inevitable 
concomitants. Mental, like physical endurance, is modified by 
age, health, development, etc.: also, a person accustomed to con- 
centration of thought, can endure a longer mental strain than 
the one inured to manual labor. One of the most injurious 
American customs, is the cultivation of the intellect at the 
expense of the physical powers. 
406. Mental Culture in Childhood. One of the 
greatest mistakes which people make in the management of their 
children, is to overtask their mental faculties. Although it is 
exceedingly gratifying to parents to see their children acquire 
knowledge, and manifest an understanding far beyond then- 
years, this gratification is often attended with a terrible expense, 
for precocious children are apt to die young. The brain and 
nervous system of children are delicate; they have not yet 
acquired the powers of endurance which older persons possess. 
The greater portion of the brain nutriment assimilated, is re- 
quired for growth and organic development, and they can ill 
afford its expenditure for mental manifestations. They receive 
impressions easier and learn much more readily than in after life, 
but it is at the expense of the physical organization. Their 
mental faculties continue to be developed by the expenditure 
of brain nutriment, while physical growth and the powers of 
endurance are arrested. The consequence of this is, that the 
physical organization is made to support the mental, and the 
once bright and healthy child, with a body unable to keep pace 
with the mind and resist the influences of disease, ekes out a 
miserable existence, or fills an early grave. It is much better 
to give physical development the precedence, that the mental COMMON SENSE MEDICAL ADVISER 
organism may be well supported and its operations carried into 
effect; for it must be apparent to all that an ordinary intellect 
in a healthy body, is capable of accomplishing infinitely more 
than a strong mind in a weak body. Fowler and Wells, in a 
work on Phrenology, say : “Would you become great mentally, 
then first become strong cerebrally. Or, would you render that 
darling boy a great man, first make him a powerf ul animal. 
Not that all powerful animals are great men, but that all great 
men are, and must needs be, powerful animals. Our animal 
nature is the basis of all mental and moral functions.” liegu- 
larity should be observed in exercising the mental functions. 
For this reason a fixed order in the pursuit of any literary occu- 
pation is very essential. The pursuit of the most abstruse 
studies will thus become habitual and comparatively easy, a 
sequence of systematic application. Mental labor should always 
cease when the train of thought becomes confused, and there is 
the slightest sensation of depression. All distracting influences 
should be absent from the mind, in order to facilitate intense 
study, as the intellect cannot attend perfectly to two subjects at 
the same time. Painful sensations always have a tendency to 
paralyze mental exertion. Great care should be taken that the 
head is not subjected to injury of any kind, as it is almost invari- 
ably accompanied by some nervous derangement. Exposure to 
extreme heat should be carefully avoided: an attack of sun-stroke, 
not immediately fatal, may occasion tumors in the brain, or some 
analogous disease. 
407. For all animated beings sleep is an imperious necessity, 
as indispensable as food. The welfare of man requires alternate 
periods of activity and repose. It is a well-established physio- 
logical fact, that during the wakeful hours the vital energies are 
being expended, the powers of life diminished, and if wakeful- 
ness be continued beyond a certain limit, the system becomes 
enfeebled and death is the,result. During sleep there is a 
temporary cessation of vital expenditures, and a recuperation of 
all the forces. Under the influence of sleep “the blood is re- 
freshed, the brain recruited, physical sufferings are extinguished, 
mental troubles are removed, the organism is relieved, and hope 
returns to the heart.” 
SLEEP. TIME FOE SLEEP. 
283 
The severest punishment which can be inflicted upon a person, 
is to entirely deprive him of sleep. In China, a few years since, 
three criminals were sentenced to be kept awake until they 
should die. To do this, it was necessary to keep a guard over 
them. The sentinels were armed with sharp-pointed instru- 
ments, with which to goad the victims and thus prevent them 
from sleeping. Life soon became a burden, and, although they 
were well fed during the time, death occurred sooner than it 
would have done had starvation been the punishment. 
408. Sleeping The sleeping room should be 
large, well ventilated, and the air within moderately cool. The 
necessity for a fire may be determined by the health of the occu- 
pant. In addition to maintaining a proper temperature in the 
room, a little fire will, no doubt, be useful — especially if in a 
grate—in securing good ventilation. The windows should not be 
so arranged as to allow a draught upon the person during the 
night, and yet so adjusted that he may obtain plenty of fresh air. 
409. The 15 ed should not be too soft, but rather hard. It 
is a pleasant thought that feathers are going out of fashion. 
They give off animal emanations of an injurious character, and 
impart a feeling of lassitude and debility to one accustomed 
to sleeping on them. No more coverings should be used than 
are necessary to the comfort of the individual. Cotton sheets 
are warmer than linen, and answer equally as good a purpose. 
410. Sleeping Alone. Certain bodily effluvia are 
thrown off from our persons, and where two individuals sleep 
together each inhales from the other more or less of these emana- 
tions. There is no doubt but that consumption, and many other 
diseases, not considered contagious, are communicated in this 
manner. When not practicable for individuals to occupy sep- 
arate beds, the persons should be of about the same age, and in 
good health. Numerous cases have occurred where healthy, 
robust children, have “ dwindled aicay ” and died within a few 
months, from sleeping with old people. Again, those in feeble 
health have been greatly benefited, and even restored, by sleep- 
ing with others whe were perfectly healthy. 
411. Time for Sleep. Night is the proper time for 
sleep. It is then that the system is in a condition to yield to 
the importunities of Morpheus, and “ seek kind nature’s sweet 284 
COMMON SENSE MEDICAL ADVISEE. 
repose.” When day is substituted for night, the sleep obtained 
will not fully restore the exhausted energies of the system, for 
nature will not. allow her laws to be broken with impunity. 
Children require more sleep than old persons, and when very 
young are about the only ones that get a sufficient amount. 
The “ troublesome little things ” are sometimes stupefied with 
“ soothing syrups,” etc., in order to get them temporarily “ out of 
the way,” thereby laying the foundation for irreparable injuries. 
This custom cannot be too emphatically condemned, for the 
child will sleep enough if it be healthy, and this disposition be 
encouraged by habits of quietude. 
412. Ifow to put Children to ISed. The follow- 
ing characteristic lines are from the pen of Fanny Fern and 
contain such good counsel that we cannot refrain from giving 
them place: “Not with a reproof for any of the day’s sins of 
omission or commission. Take any other time than bed-time for 
that. If you ever heard a little creature sighing or sobbing in 
its sleep, you could never do this. Seal their closing eyelids 
with a kiss and a blessing. The time will come, all too soon, 
when they will lay their heads upon their pillows lacking both. 
Let them at least have this sweet memory of happy childhood, 
of which no future sorrow or trouble can rob them. Give them 
their rosy youth. Nor need this involve wild license. The 
judicious parent will not so mistake my meaning. If you ever 
met the man or the woman, whose eyes have suddenly filled 
when a little child has crept trustingly to its mother’s breast, 
you may have seen one in whose childhood’s home ‘ dignity ’ and 
£ severity ’ stood where love and pity should have been. Too 
much indulgence has ruined thousands of children; too much 
love not one.” 
413. Position in Sleep. The proper position in sleep 
is upon the right side. The passage from the stomach to the 
bowels being on this side, this position favors the passage of its 
contents into the duodenum. Lying on the back is injurious, 
since by so doing the spine becomes heated, (especially is this 
the case if the person is sleeping on feathers,) the circulation 
is obstructed and local congestions are encouraged. 
414. The position of the sleeper’s head should be toward the 
north, since the magnetic currents How from north to south, and CLEANLINESS. 
285 
the nervous currents should take the same direction, so as to 
favorably influence the organic functions over which the base of 
the brain presides. The face should never be covered during 
sleep, since it necessitates the rebreathing of the same air as 
well as the emanations from the body. 
415. Tile Amount Of Sleep. The amount of sleep 
required varies with the age, habits, condition and peculiarities 
of the individual. No definite rule can be given for the gov- 
ernment of all. The average amount required, however, is 
seven or eight hours out of the twenty-four. Some persons need 
more than this, while others can do with less. Since both body and 
mind are recuperated by sleep, the more they are exhausted the 
more is required. The student, or person employed mentally, 
should have more than the one who is merely expending muscu- 
lar strength. Six hours of unbroken sleep does more to refresh 
and revive than ten when frequently interrupted. If it is too 
prolonged it weakens and stupefies both body and mind. If 
an insufficient amount is taken the flagging energies are not 
restored. Persons who eat much or use stimulants generally 
require more than others. In sleep — as with every habit — 
regularity is desirable. If a person retires at a certain hour 
for several nights in succession, it will soon become a habit. 
The same holds true with regard to rising. If children are put 
to sleep at a stated hour for several days in succession, they will 
soon become accustomed to, and really demand it. 
416. “Cleanliness is indeed next to godliness,” and is essen- 
tial to the health and vigor of the system. Its importance 
cannot be overestimated, and it should early be inculcated into 
the minds of the young. Cleanliness is the reverse of filth and 
slovenliness, and has been described as analogous to purity of 
mind. “ Even from the body’s purity, the mind receives a 
secret sympathetic aid.” 
CLEANLINESS. 
417. When we consider the functions of the skin, with its 
myriads of minute glands, innumerable little tubes—employed* in 
removing the worn-out, useless matter from the system, 80), 
we cannot fail to appreciate the utility of frequent ablutions 
with soap and water. Unless these excretions are removed, 286 
COMMON SENSE MEDICAL ADVISER. 
the glands are closed, their functions arrested, and unpleasant 
odors arise. Many persons think because they daily bathe the 
face, neck and hands, dress the hair becomingly and remove the 
dirt from their clothing that the ultimatum of cleanliness has 
been reached. In a hygienic point of view, bathing the entire 
body is of much greater importance. 
418. Notwithstanding the necessity for cleanliness of the 
body, we occasionally meet with persons who, although particu- 
lar with regard to their personal appearance, permit their bodies 
to be for weeks and even months without a bath. Such neglect 
should never exceed one week. Plenty of sunlight and at least 
two or three general baths each week are essential to perfect 
health. Cleanliness is necessary to health, beauty, attractiveness 
and a cheerful disposition. According to an ancient myth, 
beauty—the mother of love—is the daughter of the waves and 
sunlight. Water and sunlight still claim their offspring, and 
while the sunbeams aid in tinting beauty’s form, it is moulded 
into more rounded and graceful proportions by the limpid 
waters. 
419. Again, cleanliness should not only be promoted by re- 
peatedly bathing the person, but by a frequent change of clothing, 
especially of that worn next the skin. Every one must have 
observed the unpleasant odor that the socks and other under- 
clothing acquire after a few days wear. This results from the 
impurities exhaled through the skin. These impurtities should 
be removed with the clothing containing them, lest by being 
retained in contact with the skin they be reabsorbed into the 
circulation and become generators of disease. CHAPTER V. 
HYGIENE OF THE REPRO- 
DUCTIVE ORGANS. 
420. The structures and functions of organized bodies are sub- 
ject to continual alteration. The changes of nutrition and growth, 
which are constantly taking place in the tissues, are shown by 
absorption and assimilation, wThich render them at the same time 
the seat of repair and waste, of renovation and decomposition, 
of life and death. The plant germinates and blossoms, then 
withers and decays: animal life, in like manner, comes into 
being, grows to maturity, fades and dies. It is, therefore, essen- 
tial to the propagation of life, that new organisms be provided 
to take the place of those which are passing out of existence. 
There is no vital process which presents more interesting 
phenomena, or those more incapable of explanation, than that 
of reproduction, which includes the formation, as well as the 
development, of new beings. 
Since self-preservation is Nature’s first law, the desire for food 
is a most powerful instinct in all living animals. Not inferior 
to this law is that for the perpetuation of the race; and for this 
purpose, throughout the animal and vegetable kingdoms, we 
find the Biblical statement literally illustrated, “Male and female 
created He them.” 
421. Health is the gauge by which the prosperity of a people 
is measured. Were we to trace the history of nations—then- 
rise and fall—we would find that much of the license and crime, 
degradation and vice, as well as their decline and final oblivion, 
is due to the abuse of the reproductive organs. Since there is 
an intimate relation between mind and body, 157,) wThen the 288 
COMMON SENSE MEDICAL ADVISEE. 
body is enfeebled the mind becomes enervated. Morbid condi- 
tions of the body prevent the highest mental development; 
contrariwise, when the mind is debilitated, general depravity, 
physical as well as mental, is the result. The highest develop- 
ment of the body results from the equal and harmonious cultiva- 
tion of all the mental powers. The perfect development and 
health of the physical organs is therefore essential to man’s 
happiness. But before health can be insured the nature and 
general functions of the physical system must be understood. 
This being done, the question naturally arises, IIow can health 
and longevity best be maintained? 
422. IiifiueEICC Of Food. We have previously noticed 
the effects which food, exercise and other hygienic agencies, 
have upon digestion, circulation and respiration ; and we find 
that they exert a no less potent influence upon the health of the 
reproductive, than upon all of the other bodily organs. An 
excessive stimulation excites the passions and arouses the animal 
propensities. For this reason, children should not be immoder- 
ately indulged in highly seasoned viands. Those persons who 
have great muscular vigor are endowed with intense passions, 
and unless restrained by moral considerations, are very likely to 
be overcome by their vehement propensities. 
Alcoholic Stimulus has a debasing influence upon the whole 
system, and especially upon the procreative organs; it excites 
the animal and debases the moral nature 167); it exhausts 
the vitality, and, after the excitement, which it temporarily 
induces, has passed, the body is left in a prostrated condition. 
Thus drunkenness is a concomitant of sensuality. 
423. Physical Labor Modifies the Passions. 
Labor consumes the surplus vitality which a person may possess, 
and no better protective can be found against the gratification 
of the passions, unless it be high moral training, than daily toil 
extended to such a degree as to produce fatigue. Labor deter- 
mines the blood to the surface and to other parts of the body, 
and prevents morbid fluxion or excitement of the sexual centers. 
It is a well-established proposition in Hygiene, that normal 
exercise promotes the strength and development of every organ. 
If, therefore, by education or association, the passions of the 
child be excited, they will be increased. If, on the contrary, he MAN IS A SOCIAL BEING. 
289 
be taught to avoid these social or solitary evils, they will be 
abated. Let him be educated to work, and other faculties of 
the mind, with corresponding vigor, will assert their sway, the 
purposes will be strengthened, the determination intensified, and 
the body better developed, for chastity is the sequence of the 
perfect development of man. 
424. Climatic Influences. Individuals have their 
peculiarities characteristic of the nation to which they belong. 
We find that climate exerts a powerful influence upon mankind. 
In tropical regions the people are enervated, effeminate, and 
sensual. They live in luxury and ease, vice is unrestrained and 
license unbridled. Proportionately as the animal propensities 
predominate, will the mental faculties be in subjection. Hence, 
races indigenous to those latitudes rarely produce scholars or 
philosophers. Warmth superinduces the development of the 
reproductive organs. Men and women become mature at a 
much earlier age in those regions, than in countries where the 
temperature is lower. In like manner there is a tendency to 
premature enfeeblement, for the earlier the system ripens, the 
sooner will it deteriorate. 
425. Man is a Social Being. The earliest account 
of him reveals the fact, that his Creator did not design him to 
live in seclusion, for we find him with his “ helpmeet ” in his 
Eden Home. History shows that when man has been deprived 
of the society of woman, he has become reckless, vicious, 
depraved and even barbarous in his habits, thus illustrating the 
sentiment: “It is not good for man to be alone.” Associations 
promote mental and physical development—physical, because 
the body cannot be perfectly developed unless the mind be cul- 
tured. The development of a person implies the unfolding of 
every power, both physical and mental. Nothing so regulates 
and restrains passion as a healthy condition of the organs 
through which it finds expression. And every organ of the body 
is powerful in proportion to its soundness. The propensities 
play a prominent part in the education of the child. When 
properly disciplined and held in subordination to the higher 
faculties, they constitute an important factor in the economy of 
man. Boys are more liable to be morbidly excited when 
secluded from the society of girls, and vice versa. Again, when 290 
COMMON SENSE MEDICAL ADVISER. 
the sexes are accustomed to associate, the passions are not apt to 
be aroused, because of the natural, antagonizing, constitutional 
elements. The influence of the one refines, energizes and 
ennobles the other. Let children be taught to understand their 
natures, and knowing them, they will learn self-government. 
“As man rises in education and moral feeling he proportionately 
rises in the power of self-restraint; and consequently as he 
becomes deprived of this wholesome law of discipline he sinks 
into self-indulgence and the brutality of savage life.” 
426. The passions may be aroused by the language, appear- 
ance, or dress of the opposite sex. A word spoken under the 
impulse of purity, is often rendered in a very different version 
by one whose passions color the thought, and made to convey an 
impression wholly unlike that which was intended by the speaker. 
So, too, the dress may be of such a character as to excite the 
animal nature. The manner in which the apparel is worn is 
often rendered so conspicuous as to become bawdy, thereby 
appealing to the libidinous desires, rather than awakening an 
admiration for the mental qualities. 
427. Obscene Literature. Literature is a powerful 
agent either for good or evil. If we would improve the morals, 
choice literature must be selected, whether it be that which 
realizes the ideal, or idealizes the real. Obscene literature— 
books written for the express purpose of intensifying sexual 
desires in the young—goads to an illicit gratification of the 
passions and ruins the moral and physical nature. 
It not unfrequently happens that a child is born with a vigor- 
ous mental organism which gives earnest of a brilliant future, 
but manhood finds him incompetent, debilitated and totally 
incapacitated for mental or manual labor. This may be the 
result of youthful indiscretion, ignorantly committed, but not 
unfrequently it is the effect of a pernicious literature which in- 
flames the imagination, tramples upon reason, and pictures to the 
youth a realm where the passions ai’e the ruling deities. 
428. Many persons are born into the world with disordered 
organizations for which they are not responsible. Such are 
entitled to the sympathy of humanity. Dyspepsia, scrofula, 
consumption and a thousand ills to which mankind is heir, are 
transmitted from parents—the results of ill-assorted marriages. SELF-ABUSE. 
291 
Intoxicated parents engender offspring utterly demented. 
Children of healthy parents, who have good constitutions tem- 
peramentally adapted, are usually healthy and intelligent. 
Frequently in a family of children, who have the same parents, 
there are marked varieties of character. One manifests great 
precocity, another is below the average in mental attainments; 
one is amiable, another irritable in disposition; indeed, there are 
often as great differences in children of the same, as of different 
families. This is due to the physical and mental conditions of 
the parents, more especially the mother, not only at the time of 
the genesis, but also during the period intervening between 
conception and the birth of the offspring. 
429 The ancients regarded courage as the principal virtue. 
By us, purity is so estimated. Personal purity is an essential 
requisite to the growth and perfection of the character. Purity 
is inward, secret, self-sufficing, thoroughly and intimately per- 
sonal. In a word, “ purity lives and derives its life from the 
spirit of God.” In proportion as one resists temptation, is he 
virtuous. Hence, Diana should ever guard the portals to the 
highest sanctuary of the human heart, its “ holy of holies ”—• 
love and truth. 
430. Self-abuse. Untold are the miseries which arise 
from the pollution of the body. Self-abuse is one of the most 
prolific sources of evil, since it leads to the degradation of body 
and mind. It is practiced more or less by both sexes, and the 
habit once established, it is with the greatest difficulty that it 
can be overcome. It is the source of numerous diseases which 
derange the functional activity of the organs involved, and 
eventually impair the constitution. This solitary vice is often 
practiced by those ignorant of its dangerous results, and diseases 
are incurred when it is too late to redeem the broken-down 
constitution. Statistics show that insanity is frequently caused 
by masturbation. 
431. Immoderate indulgences in any practice are deleterious 
to an individual. Emphatically true is this with regard to sexual 
excesses. Not unfrequently does the marriage rite “cover a 
multitude of sins.” While moderate indulgence in sexual in- 
tercourse is conductive to health, the abuse of the marital 
relation produces the most serious results to both parties. 292 
COMMON SENSE MEDICAL ADVISER. 
Prostatorrhoea, spermatorrhoea, impotency, hypochondria, and 
general debility of the procreative organs, arise from sexual 
excesses. 
432. The health of the reproductive organs can only be 
maintained by leading a temperate life. The food should be of a 
nourishing, not stimulating, nature. Alcoholic beverages, opiates 
and narcotics, should be a Avoided. The apparel should be appro- 
priate and comfortable, but worn loosely so as not to compress 
any part, and cause congestion of the generative organs. Clean- 
liness is an essential requisite to their health; hence, frequent 
baths are indispensable. Lascivious thoughts should be dis- 
placed by cultivating a taste for that literature which is 
elevating in its nature, and the associations should be refining 
and ennobling. Let these conditions be observed, and virtue 
will reward her subjects Avitli a fine physique and noble character. 
433. Woman, from her organization, has less strength and 
endurance than man. Much, however, of the suffering and 
misery which she experiences is due to an insufficient care of the 
generative organs. The menstrual function is generally estab- 
lished between the ages of twelve and fourteen. For want of 
proper instruction, many a girl has inaugurated derangements 
which have enfeebled her womanhood or terminated her life. 
At this critical period the mother cannot be too considerate 
of her daughter’s health. Preceding the first appearance of 
the menses, girls usually feel aching in the back, pains in the 
limbs, chilliness, and general languor. The establishment of 
this function relieves the urgency of these symptoms. Irregular 
and painful menstruation may arise from inflammation of the 
uterine organs, or may be the result of contracting cold just 
before, or during the monthly flow. Every precaution should 
be taken at this period of indisposition to keep the feet dry and 
Avarm, to freely maintain a general circulation of the blood, to 
avoid overexertion, and to refrain from standing or walking too 
much. Menstrual derangements should never be neglected, 
since they predispose to affections of the brain, liver, heart and 
stomach, induce consumption and frequently end in death. 
Young women should, therefore, properly protect themselves, 
and avoid extremes of heat and cold. PART III. 
RATIONAL MEDICINE. 
CHAPTER I. 
PROGRESS OF MEDICINE. 
434. During the last half century a great change has been 
made in the treatment of disease. Medicine has advanced with 
rapid strides, from the narrow limits of mere Empiricism, to the 
broader realm of Rationalism, until to-day it comprehends all 
the elements of an Art and a Rational Science. Scientific 
researches and investigations have added many valuable truths 
to the general fund of medical learning, but much more is due 
to keen observation and empirical discovery. In a word, the 
present advancement of medicine has been attained through the 
Baconian method of Induction. It is of little or no interest to 
the invalid to know whether the prescribed remedy is organic or 
inorganic, simple, compound, or complex. In his anxiety and 
distress of body, he seeks only for relief, without regard to the 
school to which the attendant physician belongs. But this indif- 
ference of the patient does not obviate the necessity for a thor- 
ough, scientific education on the part of the practitioner. The 
question then arises, how can this requisite mental culture be 
obtained? Notwithstanding all the laws enacted to raise the 
standard of medicine, and thus protect the public from quackery, 
there yet exists a disposition among many to cling to all that 
savors of the miraculous or supernatural. To insure the future 
advancement of “ the healing art,” physicians must instruct 294 
COMM OK SEKSE MEDICAL ADVISER. 
mankind, by compiling for their perusal comprehensive works on 
Physiology, Hygiene, and Medicine. When the people under- 
stand the rationale of diseases—their cause, prevention, and cure 
—they Avill not be so easily deceived, and practitioners will be 
obliged to better qualify themselves for their labors. The prac- 
tice of medicine is yearly growing more successful. New and im- 
proved methods of treating disease are being discovered and 
developed, and the conscientious physician will avail himself of 
all the means, by a knowledge of which he may benefit his 
fellow-men. The medical profession is divided into three 
“ schools,” or sects. There are numerous divisions of minor 
importance which merit only a passing notice. 
THE ALLOPATHIC, REGULAR, OR OLD SCHOOL 
OF MEDICINE. 
435. This is the oldest existing branch of the profession. To 
it is due the credit of collecting and arranging the facts and dis- 
coveries that form the basis of “ the healing art.” It has done, 
and is doing, much to place the science of medicine on a firm 
foundation. To the text-books of this school, every student 
who would thoroughly qualify himself for medical practice must 
resort, to gain that knowledge upon which depends his future 
success. The early practice of this branch of the profession was 
necessarily crude and empirical. Conservative in character, it 
has ever been slow to recognize new theories and methods of 
practice, and has failed to adopt them until they have been 
established as incontrovertible facts. This conservatism — the 
offspring of egotism and intolerance — was manifested in its 
opposition to Ilarvey when he propounded the theory of the 
circulation of the blood, and to Jenner when he discovered and 
demonstrated the beneficial effects of vaccination. Thus has it 
ever defended its established opinions against innovation ; yet, 
out of this very conservatism has grown much real good, for, 
although it has wasted no time or energy in the investigation of 
theories, it has accepted them when established as facts. In this 
manner it has added to its fund of knowledge only those truths 
which are of real and intrinsic value. 
The practice of medicine may be divided into three eras. In 
the first, it was a system of rank empiricism. Ignorant priests HOMCEOPATHY. 
295 
or astrologers administered drugs, concerning the properties of 
which they had no knowledge, to appease the wrath of mytho- 
logical deities. In the second or heroic era, the lancet, mercury, 
antimony, opium and the blister, were employed indiscriminately 
as the sine qua non of medical practice. The present, with all 
its scientific knowledge of the human structure and functions, 
and its vast resources for remedying disease, may be aptly 
termed the liberal era of medicine. The Allopathic, differs from 
the other schools, mainly in the application of remedies. In its 
ranks are found men, indefatigable in their labors, delving deep 
into the mysteries of nature, and who, for their scientific attain- 
ments and humane principles, may justly be considered ornaments 
to society and their profession—a blessing to the race. 
436. Although this school is of comparatively recent origin, 
yet it has gained a powerful hold upon the public favor, and 
numbers among its patrons very many intelligent citizens. This 
fact alone indicates that it possesses some merit. The Homoeo- 
pathic differs from the Allopathic school principally in its “ law 
of cure,” which, according to Hahnemann, (its founder), was the 
doctrine of “ similia similibus curantur,” or “ like cures like.” 
Its method of treatment is foimded upon the assumption that if 
a drug be given to a healthy person, symptoms will occur which, 
if transpiring in disease, would be mitigated by the same drug. 
While it may be exceedingly difficult for a member of another 
school to accept this doctrine and comprehend the method 
founded upon it, yet no one can deny that it contains a measure 
of truth. Their remedies are administered in such extremely 
small doses, that their effects often seem purely imaginary. This 
fact offers a consistent demonstration of the hygienic principle 
that there exists an “ inherent vital force, the tendency of which 
is to restore, build up and maintain function and structure intact, 
the healing power of nature.” 
HOMCEOPATHY 
437. Imbued with the spirit of progress, many of its most 
intelligent and successful practitioners have resorted to the use of 
larger quantities of medicine. This school associates “Hydro- 
pathy ” with its practice, and always inculcates rigid dietetic 
and hygienic regulations. Many Homoeopathic remedies are 296 
COMMON SENSE MEDICAL ADVISER. 
thoroughly triturated with sugar of milk, which renders them 
more palatable and efficacious. Whether we attribute their 
cures to the infinitesimal doses which many Ilomceopathists 
employ, to their “law of cure,” to good nursing, or to the vis 
medicalrix naturae, it is nevertheless true that their practice is 
measurably successful. No doubt the Homoeopathic practice 
has modified that of the other schools in proving that diseases 
may be alleviated by smaller quantities of medicine than were 
formerly employed. 
ECLECTICS. 
438. This school, founded by Wooster Eeach, M. D., in oppo- 
sition to the Allopathic, or regular school of medicine, instituted 
the most strenuous opposition to the employment of Mercury, 
Antimony, the Blister and the Lancet, all of which at that time 
were considered the ultimatum—the “Alpha and Omega” of the 
recognized medical practice. The members of this new school 
boldly proclaimed that the action of heroic and noxious medi- 
cines was diametrically opposed to the operation of the vital 
forces, and proposed to substitute in their stead safer and more 
efficacious agents, derived almost exclusively from the vegetable 
kingdom. At the origin of this medical sect, in consequence of 
the indiscriminate employment of heroic remedies being fol- 
lowed by deleterious results, the public mind was prepared to 
accept any method that promised equal success without its 
dangers. The Eclectics have investigated the properties of 
indigenous plants and developed numerous valuable remedies 
from a sadly neglected field of resources which a kind and 
bounteous nature has so generously supplied for the healing of 
her children. Marked success attended the employment of 
these agents. In 1852 a committee on “Indigenous Medical 
Botany,” appointed by the “American Medical Association,” 
(Old School), acknowledged that their practitioners had been 
extremely ignorant of the medical virtues of plants, even of 
their own neighborhoods. The employment of Podophyllin and 
Leptandrin as substitutes for mercurials has been so successful, 
that they are now used by practitioners of the Old, as well as those 
of the Homoeopathic school, and large quantities are annually 
exported from this country to Europe. The spirit of this school LIBERAL OR INDEPENDENT PHYSICIAN. 
297 
has been revolutionary, and although claiming to have been 
founded upon liberal principles, it may be questioned whether its 
adherents have not been quite as exclusive and dogmatic as 
those whom they opposed. But a reaction is taking place, and 
many of its practitioners now employ some of the agents that 
they once rejected and condemned. The members of this school 
have added many important remedies to the Materia Medica and 
contributed some valuable works to medical literature. Their 
writings are important and useful contributions to the physi- 
cian’s library. Notwithstanding their imperfections they have 
achieved a glorious work and aided materially in the improve- 
ment of the practice of medicine. 
HYDROPATHY. 
439. This sect, founded by Preisnitz, believes in the efiicacy 
of Water as a cure for all diseases. While it has drawn at- 
tention to a great truth, like all other One-Idea-Pathies, it has 
erred in excluding others which are equally valuable. Instru- 
mental in overcoming the prejudice against the use of water in 
disease and proving that as a curative and hygienic agent it is of 
untold value, they have conferred a precious boon upon suffer- 
ing humanity. The author can remember the time, when sick 
and burning with fever, suffering the unspeakable torments of 
thirst, he begged for one swallow of water, which was denied 
him by the physician. But he who then prohibited this element 
is now lavish in its use. 
OTHER SECTS. 
440. Finally we have Physio-Medicalists, Mesmerists, Elec- 
tropathists, Antipathists and Clairvoyants. Each may contain 
some grains of truth, yet when considered to the exclusion of 
other doctrines, they are wofully deficient. 
THE LIBERAL OR INDEPENDENT PHYSICIAN. 
441. After this brief review of the various medical sects, the 
reader may be curious to know to which the author belongs. 
I believe that “all are but parts of one stupendous whole.” 
I am not restricted by the tenets of any medical school, but 
claim the right and privilege, nay, consider it a duty, to select 298 
COMMON SENSE MEDICAL ADVISEE. 
from all, such remedies as careful investigation, scientific research, 
and an extensive experience, have proved valuable. I resort 
to any and every agent which has been proved efficacious, 
whether it be vegetable or mineral. 
And here arises a distinction between sanative remedial agents 
and those which are noxious. Many practitioners deplore the 
nse of poisons, and advocate innocuous medicines which produce 
only sanative results. I agree with them in one proposition, 
viz: that improper medicines not only poison, but oftentimes 
utterly destroy the health and body of the patient. Every physi- 
cian should keep steadily in view the idea of final effects, as well 
as present relief, and never employ any agent without regard to 
its ulterior consequences. Nevertheless, an agent that is noxious 
in health, may prove a valuable remedy in disease. When mor- 
bid changes have taken place in the blood and tissues, when a 
general diseased action of the bodily organs has usurped the 
healthful functions, then an agent that is poisonous in health 
may prove curative. Having stated my proposition, I will give 
an illustration to substantiate its truth. It is admitted that 
alcohol is a poison ; that it prevents healthful assimilation, 
solidifies pepsin, begets a morbid appetite; that it produces 
intoxication (poisoning), and that its habitual use will eventually 
destroy the body. It is, therefore, neither a hygienic nor a 
sanative agent, but strictly a noxious one ; yet, its very distinct 
antiseptic properties render it valuable for remedial purposes, 
as these qualities will promptly arrest that fatal form of de- 
composition of the animal fluids occasioned by snake-venom, 
which produces its deadly effects in the same manner that a 
drop of yeast ferments the largest mash. Alcohol checks this 
poisonous and deadly process and neutralizes its effects. Thus, 
alcohol, although a noxious agent, sustains a special curative 
relation to a morbid state of the human system ; yet, its general 
remedial effects do not entitle it to the rank of a hygienic agent. 
I believe that medicine is undergoing a gradual change from 
the darkness of the past, with its ignorance, superstition and 
barbarity, to the light of a glorious future—the bright radiance 
of intelligent truth. At each successive step in the path of 
progress, it approximates more closely to this truth, and brings 
medicine one degree nearer the realm of an exact science. The LIBERAL OR INDEPENDENT PHYSICIAN. 
299 
common object of all medical schools is the same, viz: the alle- 
viation of human suffering. They are founded upon a common 
basis, viz: the admitted facts of Anatomy, Physiology, Chemistry 
and Surgery. The only difference is in the remedies employed, 
the size of dose administered, and the immediate results attained. 
These are insufficient grounds for bitter sectarianism. We are 
all co-laborers—students of nature. Before us lies a boundless 
held for investigation. There are new conditions of disease to 
be understood, new remedies to be discovered, and new proper- 
ties of old ones to be examined. 
442. I do not deplore the fact, that there are different 
schools in medicine, for, as this science has not reached perfec- 
tion, they tend to stimulate investigation. The remarks of Her- 
bert Spencer on the “Multiplication of Schemes of Juvenile 
Culture,” may be pertinently applied to the different schools in 
medicine and with increased force. He says: “It is clear that 
dissent in education results in facilitating inquiry by the division 
in labor. Were we in possession of the true method, divergence 
from it would, of course, be prejudicial; but the true method 
having to be found, the efforts of numerous independent seekers 
carrying out their researches in different directions, constitute a 
better agency for finding it than any that could be devised. 
Each of them struck by some new thought which probably con- 
tains more or less of basis in facts—each of them zealous on 
behalf of his plan, fertile in expedients to test its correctness, 
and untiring in his efforts to make known its success—each of 
them merciless in his criticism on the rest—there cannot fail, by 
composition of forces, to-be a gradual approximation of all 
towards the right course. Whatever portion of the normal 
method any one of them has discovered, must, by the constant 
exhibition of its results, force itself into adoption; whatever 
wrong practices he has joined with it must, by repeated experi- 
ment and failure, be exploded. And by this aggregation of 
truths and elimination of errors, there must enventually be 
developed a correct and complete body of doctrine. Of the 
three phases through which human opinion passes—the unan- 
imity of the ignorant, the disagreement of the inquiring, and 
the unanimity of the wise—it is manifest that the second is the 
parent of the third.” 300 
COMMON SENSE MEDICAL ADVISER. 
I believe the time is coming when those maladies which are 
now considered fatal will be readily cured—when disease will 
be disarmed of its terrors. To be successful, a physician must 
be independent, free from all bigotry, having no narrow preju- 
dice towards his fellow-men, liberal, accepting new truths from 
whatever source they flow, free from the stringently restrictive 
rules of “societies,” and an earnest laborer in the interests 
of the Great Physician. CHAPTER II. 
REMEDIES FOR DISEASE. 
443. It will be my aim, throughout this volume, to pre- 
scribe such remedies as are within the easy reach of all and 
which may be safely employed. Many of those of the vegetable 
class are indigenous to this country, and may be procured in 
their strength and purity, at the proper season, by those residing 
in the localities where they grow, while all others advised may 
be obtained at any respectable drug store. I will endeavor to 
recommend such as can be procured and prepared with the least 
trouble and expense to the patient, when it is believed they will 
be equally as efficacious as others. 
444. Having the invalids best interest in view, it will often 
happen that I cannot prescribe better or cheaper remedies, nor 
those that are more effective or easily obtained, than some of 
my standard preparations, which are generally sold by all drug- 
gists. I am aware that there is a popular, and not altogether 
unfounded, prejudice against “ patent medicines,” owing to the 
small amount of merit which many of them possess. The appel- 
lation, “Patent Medicine,” does not apply to my remedies, as 
no patent has ever been asked for or obtained upon them, nor 
have they been urged upon the public as “ cure-alls.” They are 
simply some favorite prescriptions' which, in a very extensive 
practice, have proved their superior remedial virtues in the cure 
of the diseases for which they are recommended. 
PROPRIETARY MEDICINES. 
445. From the time of Hippocrates the-Father of Medicine, 
down to the present day, physicians have classified diseases 
according to their causes, character or symptoms. It has been 302 
COMMON SENSE MEDICAL ADVISER. 
proved that diseases apparently different may often he cured by 
the same remedy. The reason for this singular fact is obvious— 
a single remedy may possess a variety of properties. Quinine, 
among other properties, has a tonic quality which suggests its use 
in cases of debility; an antiperiodic, by which it is efficient in ague; 
and a febrifuge property which renders it efficacious in cases 
of fever. The result produced will vary with the quantity given, 
the time of its administration, and the circumstances under which 
it is employed. Every practicing physician has his favorite 
remedies, which he oftenest recommends or uses, because he has 
the greatest confidence in their virtues. The patient does not 
know their-composition. Even prescriptions are usually written 
in a language unintelligible to any but the druggist. As much 
secrecy is employed as in the preparation of proprietary medi- 
cines. Does the fact that an article is prepared by a process 
known only to the manufacturer render that article less valuable ? 
How many physicians know the elementary composition of the 
remedies which they employ, some of which have never been 
analyzed? Few practitioners know how Morphine, Quinine, 
Podophyllin, Leptandrin, Pepsin, or Chloroform, are made, or 
how nauseous drugs are transformed into palatable elixirs ; yet 
they do not hesitate to employ them. Is it not inconsistent to 
use a prescription, the composition of which is unknown to us, 
and discard another preparation simply because it is accompanied 
by a printed statement of its properties with directions for its 
use ? What makes a medical prescription or compound pro- 
prietary ? Let us lay aside all prejudice, and examine the facts. 
It is obvious that a physician engaged in an extensive practice 
cannot find time to write all his prescriptions, their uses, etc., 
etc. Printing them saves much time and manual labor, which 
can be more advantageously employed ; and yet our Government 
forbids the use of printed labels on bottles without the addition 
of a revenue stamp. All medicines thus prepared are termed 
proprietary. Thus, I am now obliged by law, either to write 
full directions and advice, or else, if I print them and paste them 
on the bottles, they are regarded as proprietary medicines and 
must be stamped as such. My practice long since became so 
extensive that I could not possibly write out all directions, even 
had I preferred so to do. Putting up in a uniform and peculiar PROPRIETARY MEDICINES. 
303 
style, and designating by certain definite names those com- 
pounds which, from their superior virtues have become favorites 
in my practice, and consequently have been most frequently 
prescribed for certain ailments, throws around them the protec- 
tion of the common laws of all civilized countries, which 
recognize the exclusive right to the use of any peculiar mark or 
style of wrapper that proprietors may adopt as their Trade 
Mark, whereby their goods may be distinguished. Thus the 
people are protected against fraud and imposition, being sure of 
getting a genuine article, if they observe the peculiar design, 
color and style of wrappers in which the medicines are enclosed; 
while it renders them none the less valuable because the exclu- 
sive right to manufacture them is vested in a single individual. 
Because Vanderbilt possesses vast railroad interests, are railroads 
less valuable ? Because a certain merchant prince controls the 
manufacture of cotton goods, is cotton cloth less useful ? Be- 
cause the Government retains the exclusive right to manufacture 
coin and currency, is the gold dollar of less value ? 
446. Swift says that “ censure is the tax a man pays to the 
public for being eminent.” Envious people are always jealous 
of the prosperity of others, and love to detract from their repu- 
tation. Occasionally, bitterness is aroused and invectives are 
hurled at me by physicians whose patients have been cured 
by my remedies. Several attempts to injure the reputation 
acquired by my standard preparations have been unmistakably 
traced to such a source. Nor is this spirit evinced only by 
Americans. 
Sometime since the Industrie Blatter, a periodical published 
in Berlin, Prussia, and laying claims to a scientific character, 
published what was represented as being the formulae or receipts 
for making Dr. Sage’s Catarrh Remedy and Dx*. Pierce’s Golden 
Medical Discovery. The people were left to infer that these had 
been deducted from a careful chemical analysis of the medicines 
which were rapidly growing in popular favor in that, as well as 
in this and other civilized countries. The receipts were evi- 
dently invented by those jealous of the reputation and large 
sale of these medicines, and who were pecuniarily interested in 
endeavoring to check their sale. Notwithstanding, however, that 
the bogus receipts were so ridiculously preposterous as scarcely 304 
COMMON SENSE MEDICAL ADVISER. 
to have been believed by the most unscientific, thoughtless and 
unsuspecting people, yet a paper of very high scientific preten- 
sions, published in this country, copied the fictitious receipts 
from the German periodical. This they evidently did without a 
moment’s reflection, for any consideration given by an intelligent 
mind to the receipts which contained well-known caustic and 
poisonous chemicals, would have condemned them as bogus fab- 
rications, and proved the pretentious publishers of the paper 
that originally inserted them, either knaves or fools. On my 
attention being called to the matter, in order that some thought- 
less and over credulous people might not be deceived and 
misled by seeing such an announcement, as well as to prove 
myself guiltless of perpetrating a wicked fraud upon the people, 
I went before a magistrate and made an oath to the fact that the 
said receipts were utterly false. My affidavit was sent to the 
publishers of the paper into which the bogus receipts had been 
copied, and in a subsequent issue an editorial notice was given 
to this effect. 
447. Several medical and pharmaceutical journals of this 
country have published equally absurd formulae, purporting to 
be the receipts for Dr. Sage’s Catarrh Remedy and several of 
my other standard preparations. In refutation of all such 
reports, concocted by jealous physicians and rivals in the manu- 
facture of medical compounds, I defy all the chemists in the 
world to ascertain, by analysis, the composition of any of my 
Family Medicines, as they contain ingredients that are new in 
medicine, and like nearly all vegetable extracts, there are no 
known re-agents, or chemical tests, by which their nature can be 
determined. 
By the publication of these false reports, certain individuals, 
who lounge around and infest our lage cities, gaining a livelihood 
by perpetrating all kinds of frauds upon the credulous, were there- 
by given the hint, that my medicines were universally popular, 
and that by advertising for sale bogus receipts for making them 
they could get lots of ignorant people to buy them. One Frank 
M. Reed, of 139 Eighth Street, New York, who publishes “Love 
and Courtship Cards,” a “ Fortune Teller and Dream Book,” 
“The Mysteries of Love Making,” “How to Woo and How to 
Win,” and various other swindles, sends his dupes the following FKOPRIETARY MEDICINES. 
305 
in exchange for their stamps. It is copied from the papers 
alluded to and is as follows: “For Dr. Sage’s Catarrh Remedy 
take eight grains Carbolic Acid, seven grains of Camphor, and 
two and a half grains of common Salt, the whole to be colored 
with a little Prussian blue.” This makes a powerful caustic 
mixture as unlike Dr. Sage’s Catarrh Remedy (which is perfectly 
unirritating, mild, soothing and pleasant) as light is from dark- 
ness. As “ a burnt child dreads the fire,” so if any have been so 
foolish as to have burned their noses with this caustic compound, 
thinking that they were using the same as Dr. Sage’s celebrated 
Catarrh Remedy, they will, I hope, profit by the lesson thereby 
taught them and not be so ready to bite at every catchpenny 
advertising dodge that swindlers may offer them. For my 
Golden Medical Discovery the bogus receipt reads: “Take four 
drachms purified Honey, fifteen grains extract poisonous Lettuce, 
thirty grains of Opium, three and a fourth ounces dilute Spirits, 
three ounces water. Mix.” Of this ridiculous bogus formula 
I will say, as I did under oath, not one of the medicinal or 
poisonous ingredients therein given enters into the composition 
of my Golden Medical Discovery. If further proof is required 
to satisfy any person that the receipt given above is utterly 
false let that person have the mixture, as given, compounded, 
and, not only will it be seen to be entirely unlike my Discovery 
in appearance,-but if a further test is wanted, let a dose of it 
be taken. It will produce drowsiness and stupor, whereas my 
Discovery, taken in ever so large doses, produces no such effect. 
Other swindlers, located in different cities, and engaged in ad- 
vertising for sale bogus receipts for making my medicines, send 
other ridiculous formulae. One, sent out by a villainous knave 
located in Chicago, gives Blue Vitriol as the chief ingredient of 
Dr. Sage’s Catarrh Remedy. This is only equaled in absurdity 
by another issued by parties in Philadelphia, in which the in- 
gredients of Dr. Sage’s Catarrh Remedy are given as “burnt 
Alum, white Vitriol, Sugar of Lead, and Prussiate of Iron,” 
and of my Golden Medical Discovery as “simple Syrup and 
Tincture of Ginger.” 
448. In refutation of the various and ridiculous bogus 
receipts for making my medicines that have or may hereafter be 
published and circulated, I would say that I have, in dealing COMMON SENSE MEDICAL ADVISEE. 
with the people, ever been governed by the maxim that, “hon- 
esty is the best policy,” and that “success makes success.” 
Thousands of sufferers have obtained relief by the use of my 
remedies, and have thus been induced to recommend them to 
other thousands of sufferers. In this way I am constantly 
making living advertisements for myself and medicines. It is a 
common thing to hear people say that plenty of advertising will 
make a success out of anything, whether it has any merit or not. 
Nothing could be farther from the truth. Actuated by this 
delusive idea, thousands have rushed headlong into advertising, 
only to find themselves bankrupt in a little time. Not more than 
one in five hundred who engages in advertising medicines ever 
makes the undertaking a financial success, for the reason that a 
medicine to be successful, must possess unusual and extraor- 
dinary merit. It is not enough that it should be a remedy of 
fair efticac-y ; it must possess superior and wonderful remedial 
properties, for if it does not, those who use it with the most 
sanguine expectations will condemn it. They will expect much 
of it, and it must be equal to the test, or the proprietor will be 
ruined. For although a great display will, many times, create 
a considerable immediate demand for the article advertised, yet 
if that article , does not possess real merit, this demand will be 
only temporary ; the fraud will be detected, and the reaction 
will upset the proprietor and all his high expectations, long before 
he is able to recover the amount of money already expended. 
With this view of the subject, I have felt warranted in expending 
many hundred thousand dollars in advertising through the news- 
papers of this and other countries, feeling perfectly assured that 
the mei'its of my remedies were so great as to insure a financial 
success. And in this I have not been disappointed, for my sales 
have increased steadily year by year, until they exceed half a 
million dollars per annum. This grand success could never have 
been attained, had the medicines not possessed remarkable 
healing virtues. 
The Toledo Blade, in an editorial alluding to my business, 
contains the following: “Great success is never achieved with- 
out merit. An article that holds the field year after year, and 
the sales of which increase regularly and rapidly, must have 
absolute merit.” The article continues: “Dr. R. V. Pierce, of PROPRIETARY MEDICINES. 
307 
Buffalo, N. Y., occupies our entire eighth page to-day with his 
various articles. We admit it because we know the Doctor, and 
know of his articles. We know him to be a regularly educated 
physician, whose diploma hangs on the wall of his office, and we 
know that he has associated with him several of the most emi- 
nent practitioners in the country. We know that parties consult 
him, by mail and in person, from all the States in the Union 
every day, and that they are fairly and honestly dealt with. We 
know that his medicines are sold in enormous quantities in every 
State in the Union, and very largely in many foreign countries. 
This grand result has been accomplished by two agencies: good, 
reliable articles—articles which, once introduced, work easily 
their own way—and splendid business management. They have 
succeeded because they ought to have succeeded.” 
The course which has been pursued by some jealous, narrow- 
minded specimens of humanity, is in decided contrast to the 
conduct of those noble, liberal-minded men, whose consciences 
will not allow them to reject a good remedy simply because it 
is proprietary. That my medicines are esteemed by this portion 
of the profession, is proved by the fact that I receive many 
letters of consultation from eminent physicians. Frequently 
they ask my counsel in cases of sickness occurring in their own 
families. They can perceive the advantages I have gained by 
confining my attention to specialities, and thus acquiring greater 
skill in those departments. 
449. In the manufacture of any pharmaceutical preparation, 
two conditions are essential to its perfection, viz : purity and 
strength of the materials, and appropriate machinery. The first 
is insured, by purchasing the materials in large quantities,whereby 
the exercise of greater care in selecting the ingredients can be 
afforded; and the second can only be accomplished where the 
business is extensive enough to warrant a large outlay of capital 
in procuring proper chemical apparatus. These facts apply with 
especial force to the manufacture of my medicines, their quality 
having been vastly improved since the demand has become so 
great as to require their manufacture in very large quantities. 
Some persons, while admitting that my medicines are good 
pharmaceutical compounds, object to them on the ground that 
they are too often used with insufficient judgment. I propose 308 
COMMON SENSE MEDICAL ADVISER. 
to obviate this difficulty by enlightening the people as to the 
structure and functions of their bodies, the causes, character, 
and symptoms of disease, and by indicating the proper and 
judicious employment of my medicines, together with such 
auxiliary treatment as may be necessary. Such is one of the 
designs of this volume. 
PROPERTIES OF MEDICINE. 
450. It is generally conceded that the action of a remedy 
upon the human system depends upon its peculiar properties. 
The effects produced suggest the naming of these qualities, 
which have been scientifically classified. I shall name the 
disease from its characteristic symptoms, and then, without 
generally commenting upon all the properties of a remedy, 
recommend its employment. My reference to the qualities of 
any remedy, when I do make a particular allusion to them, I 
shall endeavor to make as easy and familiar as possible. 
451. Hose. All persons are not equally susceptible to the 
influence of medicines. As a rule, women require smaller doses 
than men, and children less than women. The babe is very sus- 
ceptible to the effects of an anodyne, even out of all proportion, 
relatively, to other kinds of medicines. The circumstances and 
conditions of the system increase or diminish the effects of medi- 
cine, so that an aperient at one time may act as a cathartic at 
another, and a dose that will simply prove to be an anodyne 
when the person is suffering great pain, will act as a narcotic 
when he is not. And this explains, to an extent, why the same 
dose will affect individuals differently, without taking into 
account the different temperaments or degrees of natural suscep- 
tibility. The following table is given to indicate the size of the 
dose, and is graduated to the age: 
YEARS. DOSE. 
21 . . . . full. 
15 .... 2-3 
12 ... 1-2 
8 .... 1-3 
6 . 1-4 
YEARS. DOSE. 
4 . . . . 1-6 
2 1-8 
1 1-12 
% . . . 1-20 to 1-30 
The doses mentioned in the following pages are proportioned 
for adults, unless otherwise directed. PREPARATION OF MEDICINES. 
309 
452. TIae Freimraticm ©f* Medicines. The rem- 
edies that I shall mention for domestic use are mostly vegetable. 
Infusions and decoctions of these will many times be advised on 
account of being more available than the tinctures, fluid extracts 
and concentrated principles, which I prefer, and almost invaria- 
bly employ in my practice. Most of these medicinal extracts 
are prepared in my chemical laboratory under the supervision of 
a careful and skilled pharmaceutist. No one, I presume, would 
expect, with only a dish of hot water or a stew kettle, to equal 
in pharmaceutical skill the learned chemist with all his inge- 
niously devised and costly apparatus for extracting the active 
remedial principles from our medicinal plants. Yet infusions 
and decoctions are not without their value; and from the 
inferior quality of many of the fluid extracts and other pharma- 
ceutical preparations in the market, it may be questioned whether 
the former are not frequently as valuable as the latter. So 
unreliable are a majority of the fluid extracts, tinctures and 
concentrated active principles found in the drug stores, that I 
long since found it necessary to have prepared in my laboratory, 
most of those that I employ. And to the reliability of the 
preparations that I secure in this way, I largely attribute my 
greatly increased success in the treatment of disease. Many 
times tinctures and fluid extracts are prepared from old and 
worthless roots, barks and herbs, that have wholly lost their me- 
dicinal properties. Yet they are sold at as high prices as those 
that are good. I have my tinctures, fluid extracts and concen- 
trated active principles, manufactured from roots, barks and herbs 
that are fresh, and selected with the gi’eatest care, when not dug 
or gathered specially for me, as most of them are. Many of the 
crude roots, barks and herbs found in the market are inactive 
from being gathered out of their season of maturity. And these, 
together with those that have been kept on hand so long as to 
have lost all medicinal value, are many times sold in large quan- 
tities and at reduced prices to be manufactured into fluid extracts 
and tinctures. Of course the preparations made from such 
materials are utterly worthless. Whenever the dose of fluid 
extracts, tinctures, and concentrated active principles, is men- 
tioned in this chapter, the quantity advised to be taken is based 
upon my experience in the use of these preparations, as they are 310 
COMMON SENSE MEDICAL ADVISER. 
made in my laboratory, and the smallest quantity that will pro- 
duce the desired effect is always given. In using most of the 
preparations found in the drug stores, the doses have to be 
somewhat increased, and will not then always produce the 
desired effect, for reasons already given. 
453. The Sjist ©f* Medicines that I shall introduce 
in this chapter will be quite limited, as I cannot hope, by making 
it extensive, that the non-professional reader would be able to 
prescribe with good judgment other than the simpler agents. 
Hence, I prefer, as I have no space in this volume to waste, to 
mention only a few of the most common remedies under each 
head or classification. 
454. Tinctures. Very uniform and reliable tinctures 
may be made of most of our indigenous plants, by procuring the 
part to be employed, at the proper season, and, while it is green 
and fresh, bruising it well and covering it with good strong 
whisky, or with alcohol diluted with about one part of water to 
three of alcohol, corking tightly and letting it stand about four- 
teen days, when the tincture may be filtered or poured off from 
the drugs, and will be ready for use. Prepared in this imperfect 
manner, they will be found to be much more reliable than many 
of the fluid extracts found in the drug stores. An excess of the 
crude drug should be used in preparing the tincture to insure a 
perfect saturation of the alcohol with its active principles. 
455. Homoeopathic Tinctures. The tinctures pre- 
pared by several of the German and French pharmaceutists, and 
called by them “Mother Tinctures,” to distinguish them from 
the dilutions made therefrom, I have found to be very reliable, 
so much superior to any similar preparations made in this coun- 
try that I regularly purchase from them all I use of Pulsatilla, 
Staphisagria, Drosera and several others. They are prepared 
with great care from the green, crude material, and although 
high in price, when compared with other tinctures, yet the greater 
certainty of action that I secure in my prescriptions by their 
employment more than repays for the expense and trouble in 
procuring them—for of what account is expense to the true 
physician when life may depend upon the virtue of the agent 
he employs ? 
456. Infusions. These are generally made by adding ALTERATIVES. 
311 
one-half ounce of the crude medicine to a pint of water, which 
cover closely, keep warm, and use as directed. Flowers, leaves, 
barks and roots become impaired by age, and it is necessary to 
increase or diminish the dose according to the strength of the 
article employed. 
457. Decoctios&s. The difference between a decoction 
and an infusion is, that the plant or substance is boiled, in the 
production of the former, in order to obtain its soluble medicinal 
qualities. Cover the vessel containing the ingredients, thus con- 
fining the vapor, and shutting out the atmospheric air which 
sometimes impairs the active principles and their medicinal 
qualities. The ordinary mode of preparing a decoction is to 
use one ounce of the plant, root, bark, flower or substance to a 
pint of water. The dose internally will vary from a table- 
spoonful to one ounce. 
ALTERATIVES. 
458. Alteratives are a class of medicines that in some inex- 
plicable and insensible manner, gradually change certain morbid 
actions of the system, and establish a healthy condition instead. 
They stimulate the vital processes to renewed activity, and 
arouse the emunctories to remove matter that ought to be ex- 
creted. They facilitate the action of the secretory organs, tone 
them, and give a new impulse to their operations, so that they 
can more expeditiously rid the system of worn-out and effete 
materials. In this way they alter, correct and purify the fluids, 
tone the organs and re-establish their healthy functions. Alter- 
atives may possess also tonic, laxative, stimulant or diuretic 
properties, or all of these may be combined in one agent. Or 
we may combine several alteratives in order to unite these 
different medical properties in one remedy. Some alteratives 
operate as a purgative in large doses, and require to be taken in 
diminished or broken doses. Generally, this class of remedial 
agents are given in proper doses, three or four times daily. I 
propose to enumerate only a few alteratives, and the doses that 
are usually prescribed; the list that I employ in my practice is 
very extensive, but cannot be made available for domestic use. 
459. Mandrake {Podophyllum Peltatum), also called 
May-Apple, is a most valuable vegetable alterative. The root 312 
COMMON SENSE MEDICAL ADVISER. 
is the part used. Dose—Of decoction, one to two teaspoonfuls; 
of tincture, six to eight drops; of fluid extract, three to five 
drops; of its active principle — Podophyllin — one-twelftli to 
one-eighth grain. 
460. Poke {Phytolacca Decandra). Also called Skoke, 
Garget, Pigeon-Berry, etc. This is a valuable alterative. The 
root is the part used. Dose—Of decoction, one to three teaspoon- 
fuls; of fluid extract, three to ten drops; concentrated principle— 
Phytolaccin—one-fourth to one grain. 
461. Yellow Hock (Rumex Crispus). Part used—the 
root. Dose—Of the infusion, one to three fluid ounces three 
times daily; fluid extract, ten to thirty drops; tincture, twenty 
to forty drops. 
462. ISlirdoek {Arctium Lappa). The root is the part 
used. Burdock is a valuable alterative in diseases of the blood. 
Dose—Of tincture, one teaspoonful to a tablespoonful twenty 
minutes before meals; fluid extract, one to two teaspoonfuls. 
463. Tag Alder (Alnus Rubra). Known as the Smooth, 
Fig. 113. 
Tag Alder. 
Common, or Swamp Alder. The bark is the part used. Excellent 
in scrofula, syphilis, cutaneous and all blood diseases. Dose— ALTERATIVES. 
313 
Of decoction, one to two tablespoonfuls three to five times daily; 
of tincture, one to two teaspoonfuls; fluid extract, one-half to 
one teaspoonful; concentrated principle—Alnuin—one-half to 
one grain. 
464. Black ColiOSlft (Macrotys or Cimicifuga liace- 
mosa). Part used—the root. Common names are Black Shake- 
Hoot, Rattle-Root, Squaw-Root, etc. Black Cohosh is alterative, 
Fig. llJf. 
Black Cohosh. 
stimulant, nervine, diaphoretic, tonic and a cerebro-spinal stimu- 
lant. It is a useful, active and valuable remedy. Dose—Of 314 
COMMON SENSE MEDICAL ADVISER. 
decoction, one-fourth to one ounce; tincture, ten to fifteen 
drops; fluid extract, five to ten drops; concentrated principle— 
Macrotin,—one-eighth to one-lialf grain. 
465. ISlood-Root (Sanguinaria Canadensis), also known 
as Red Puccoon. Part used — the root. In minute doses 
Blood-Root is a valuable alterative, acting upon the biliary secre- 
Fig. 115. 
Blood-Koot. 
tion, improving the circulation and nutrition. Dose—Of pow- 
dered root, one-fourth to one-half grain; of tincture, one to two ALTERATIVES. 
315 
drops; fluid extract, one-half to one drop. When given in fluid 
form it should be well diluted. 
466. MlllC Elag (Iris Versicolor). Part used—the root. 
Dose—Of the tincture, five to ten drops; of fluid extract, three 
to ten drops; of concentrated principle—Iridin—one-half to two 
grains. 
467. Sweet Elder (Sambucus Canadensis). Sweet 
Elder-Flowers are a valuable alterative, diuretic, mucous and 
glandular stimulant, excellent in eruptive, cutaneous and scrofu- 
lous diseases of children. An infusion, fluid extract or syrup, 
may be used when taking the Golden Medical Discovery. Both 
will be found invaluable for cleansing the blood and stimulating 
the functions to a healthy condition. Dose—Of the infusion of 
the flowers, from one-half to one ounce—if freely taken, will 
operate as a laxative; fluid extract, one-fourth to one-half tea- 
spoonful. The flowers, or inner bark of the root, simmered in 
fresh butter, will make a good ointment for most cutaneous 
affections. 
468. Iodine. This agent, in the several forms of Iodide 
of Potassium, Iodide of Ammonium, Iodide of Iron and Iodide 
of Lime, is largely employed by physicians, and many times 
with most happy results. But for domestic use I cannot advise 
its employment, as it is liable to injure the invalid, when its ac- 
tion is carried too far, which is apt to be the case, when not 
administered under the observation of a competent physician. 
469. Mercurials. I would merely remark in this con- 
nection, that there are yet a few practitioners, who firmly be- 
lieve in the remedial efficacy of mercurials, and employ them 
largely as alteratives and cathartics. My experience, however, 
embracing yearly the treatment of thousands of cases of chronic 
diseases, many very complicated, and which had already been 
subjected to the use of this class of medicines without improve- 
ment, indicates to me that there are far more speedy, safe and 
efficacious remedies for the restoration of the sick. Not only 
are mercurials objectionable because they act so slow, but the 
affinities of their elements cause them to unite with the tissues 
of the body in such a manner as to permanently injure its struc- 
tures. Therefore it is a decided improvement in practice to be 
able to substitute safer and better remedies. 316 
COMMON SENSE MEDICAL ADVISER. 
THE COMPOUNDING OF ALTERATIVES. 
470. The efficacy of this class of remedies can be greatly 
increased by properly combining several of them into one com- 
pound. This requires a knowledge of Pharmaceutical Chemis- 
try; i. e., the preparation of compounds founded on the chemical 
relation and action of their several remedial active principles. 
Many practitioners make combinations of properties which neu- 
tralize each other’s influence, instead of embracing their efficacy 
and increasing their remedial power. 
471. Dr. Pierce’s Crolden Medical Discovery, 
or Alterative Extract. This compound is a highly nutritive and 
tonic preparation, combining the remedial properties of the best 
vegetable alteratives at present known to the medical profession. 
In perfecting this alterative compound, and likewise other 
standard preparations of medicine, I have made an outlay of 
many thousand dollars for chemical apparatus, machinery, etc., 
finally bringing my remedies to their present perfection, by a pro- 
cess entirely original with myself. Great pains are taken to ob- 
tain the vegetables at the right season of the year, properly cured, 
so that none of their remedial qualities will be impaired. Under 
these circumstances, I can with great confidence recommend my 
Golden Medical Discovery as one of the very best preparations 
of the alterative class. Like all others of this type, its action is 
insensible, producing gradual changes, arousing the emunctories 
to remove morbid materials, and at the same time toning the 
secretory organs. The manufacture of this compound is under 
the special supervision of a competent chemist and pharma- 
ceutist, and it is now put up in bottles wrapped with full direc- 
tions for its use. I can confidently recommend this compound 
whenever an alterative is required to cleanse the blood, tone the 
system, increase its nutrition, and establish a healthy condition. 
For these reasons, I shall often advise its employment. 
472. Dr. Pierce’s Pleasant Purgative Pellets. 
These pellets combine the pure, concentrated, active principles 
of several vegetable alteratives, and the result is, that within the 
small compass of a few grains, I have most happily blended and 
chemically condensed these properties, so that their action 
upon the animal economy is sanative and universal. They ACIDS 
317 
awaken the latent powers, quicken the tardy functions, check 
morbid deposits, resolve hard concretions, remove obstruc- 
tions, promote depuration, harmonize and restore the functions, 
equalize the circulation and encourage the action of the nervous 
system. They stimulate the glands, increase the peristaltic move- 
ment of the intestines, tone the nutritive processes, while aiding 
in evacuating the bowels. All this they accomplish without 
corroding the tissues or vitiating the fluids. Their assistance is 
genial, helping the system to expel worn out materials, which 
would become noxious if retained. Having expended their 
remedial powers upon the various functions of the body, 
they- are themselves expelled along with other waste matter, 
leaving behind them no traces of irritation. This cannot be said 
of mercurials, or of other harsh mineral alteratives. These 
Pellets may be safely employed when the system is feeble, frail 
and delicate, by giving them in less quantities. Dose—As an 
alterative, only one or two Pellets daily. 
ALKALIES. 
473. Alkalies. These constitute an important list of 
remedial agents, their administration being frequently indicated. 
The employment of other medicines many times, will have to be 
preceded by the administration of an agent of this class, to 
neutralize excessive acidity in the stomach and bowels. Unless 
this is done, many medicines will fail in producing their specific 
effects. 
474. Sulphite Of* Soda (>Soclce Salphis). This salt, as 
well as the Hyposulphite of Soda, is not only generally preferable 
for administration on account of its unirritating character, and 
the smallness of the dose required, but also because it is a valua- 
ble antiseptic agent. The Sulphite must not be confounded with 
the Sulphate of Soda (Glauber’s Salt). Dose—Three to ten grains. 
475. Salaeratias (Dotassce Dicarbonas). This is a favorite 
domestic anti-acid. Dose—Five to fifteen grains. 
ACIDS. 
476. As Alkalies are important and oft-indicated remedial 
agents, so their re-agents—Acids—are also frequently demanded 
to meet opposite conditions of the fluids of the system. 318 
COMMON SENSE MEDICAL ADVISER. 
477. Muriatic Acid. This agent may be exhibited in 
doses of from five to ten drops, largely diluted in water or gruel. 
478. Aromatic Sulphuric Acid, or Elixir of 
Vitriol, affords the most agreeable form of Sulphuric Acid for 
administration, and may be given in doses of from five to fifteen 
drops, largely diluted with water. 
In taking acids, they should be sucked through a straw, and 
not allowed to come in contact with the teeth, as otherwise the 
latter organs will be injured by their effect; or should the acid 
come in contact with the teeth, the mouth should be immediately 
rinsed with a solution of salaeratus or soda, to neutralize the 
acid. 
ANODYNES. 
479. Anodynes are those medicines which relieve pain by 
blunting the sensibility of the nerves, or of the brain, so that it 
does not appreciate the morbid sensation. An Anodyne may 
prove to be a stimulant in one dose, and a narcotic in a larger one. 
The properties of different anodyne agents vary, consequently 
they produce unlike effects. The size of the dose required, 
differs according to circumstances and condition. Children can 
safely take only minute doses. Their nervous system is remark- 
ably susceptible to the action of this class of medicines. An 
adult, suffering acute pain, requires a much larger dose to pro- 
duce an anodyne effect, than one who is a chronic sufferer. An 
individual accustomed to the use of Anodynes, requires a much 
larger dose to procure relief, than one who is not. Doses may be 
repeated, until their characteristic effects are pi’oduced, after an 
interval of thirty or forty minutes. When the stomach is very 
sensitive and will not tolerate their internal administration, one- 
sixth of a grain of Morphia can be inserted beneath the skin, 
by means of a hypodermic syringe. Relief is more quickly 
experienced, and the anodyne effect is much more lasting, than 
when taken into the stomach. 
480. Opium (Papaver Somniferum). Opium is a stimu- 
lant, anodyne and narcotic, according to the size of the dose 
administered. Dose—Of the dry powder, one-fourth, one-half, 
to one grain; tincture (Laudanum), five to fifteen drops; cam- 
phorated tincture (Paregoric), one-half to one teaspoonful; ANODYNES. 
319 
Morphine, one-eighth to one-fourth grain; Dover’s Powder, 
three to five grains. 
481. llyoscyaiims (Hyoscyamus Niger). Herb. Hen- 
bane is a powerful narcotic, and, unlike Opium, does not constipate 
the bowels, but possesses a laxative tendency. Therefore it may 
be employed as an anodyne in allaying pain, calming the mind, 
inducing sleep and arresting spasms, when opiates are inadmis- 
sible. Dose—Alcoholic extract, one-half to two grains; fluid 
extract, five to ten drops; concentrated principle — Hyoscyamin 
—one-twelfth to one-fourth of a grain. 
482. Poison Hemlock (Conium Maculatum). The 
leaves. Poison Parsley as it is known to some, is an anodyne, 
Fig. 116. 
Poison Hemlock. 
narcotic and excellent alterative. Dose—Of fluid extract, two 
to six drops; solid extract, one-fourth to one-half grain. 320 
COMMON SENSE MEDICAL ADVISER. 
483. Melladoimst (Atropa Delladonnd). The herb or 
leaves. The Deadly Nightshade is a valuable, though in large 
doses, a powerful agent. In overdoses, it is an energetic, nar- 
cotic poison. In medicinal doses, it is anodyne, antispasmodic, 
diaphoretic and diuretic. Excellent in neuralgia, epilepsy, 
mania, amaurosis, whooping-cough, stricture, rigidity of the os 
uteri, and is a prophylactic (preventive) of Scarlet Fever. 
Its influence upon the nervous centers is remarkable, relaxing 
the blood vessels on the surface of the body and inducing capil- 
lary congestion, redness of the eye, scarlet appearance of the 
face, tongue and body. Dose—Fluid extract, one-half to one 
drop; tincture, one to two drops; concentrated principle— 
Atropin—one-thirtieth to one-sixteenth of a grain; Alkaloid 
Atropia, one-sixtietli of a grain. Even the most skillful chemists 
are very cautious in compounding these latter active principles, 
and the liability to an overdose is great. 
484. CamplEOr. This drug is anodyne, stimulant, dia- 
phoretic, and in large doses, narcotic and irritant. This valuable 
domestic remedy enters into the diaphoretic powders of the 
Eclectics, which are very serviceable for anodyne purposes. It 
is an excellent stimulant for liniments. Dose—Of the powder 
one to five grains; tincture, ten to twenty drops, in simple 
syrup. 
485. Mops (Humulus Lupulus). This is an excellent rem- 
edy in wakefulness, and may be used when opium is contra- 
indicated. A bag of the leaves, moistened with whisky and 
placed as a pillow under the head, acts as an anodyne. Dose— 
Drink freely of an infusion of the leaves; fluid extract, one- 
fourth to three-fourths of a teaspoonful; concentrated principle 
—Lupulin—one to three grains. 
486. Dr. Fierce’s Compound Extract of 
Smart-Weed. This anodyne compound is made by uniting 
several of the most valuable agents of this class, and its medic- 
inal qualities are rendered still more efficacious by the addition 
of certain stimulating articles. It is free from narcotic proper- 
ties, which are liable to produce deleterious results, and will be 
found to be not only harmless in its action, but very genial and 
effectual withal and most reliable as a stimulant and diaphoretic 
remedy. ANTHELMINTICS. 
321 
ANTHELMINTICS. 
487. Anthelmintic means “ against ” a “worm,” and is a word 
employed to designate those medicines that destroy or expel 
worms. It means the same as Vermifuge. Little is under- 
stood concerning the origin of worms, but there are five distinct 
varieties described by authors, as being more common than 
others. There is the long worm, the short, or pin-worm, the 
thread-worm, the tape-worm and the broad tape-worm peculiar to 
some of the old countries. Irritation of the alimentary canal 
from whatever cause, usually produces an abundant secretion of 
mucus, which is thought to be a condition favorable to their 
production. Therefore, those medicines which remove the cause 
of this irritation tend to diminish the number, if not entirely 
destroy the worms. Some medicines kill the worms, others expel 
them alive. The remedies that successfully remove one kind of 
worm, have little effect upon another, and to meet these differ- 
ent conditions, we have a variety of worm-destroying medicines. 
The pin-worm inhabits the rectum, and may be destroyed by 
injecting into it a strong solution of salt, and when it is allowed 
to pass away, the rectum should be anointed with blitter or 
lard. The eggs of this worm are developed around the orifice 
of the large intestine, and when this latter precaution is not 
practiced every time there is a passage from the bowels, they will 
multiply as rapidly as they can be destroyed. Generally, ver- 
mifuge remedies should be taken when the stomach is empty, 
and should be followed by the use of a cathartic in two hours 
after the last dose is administered. 
488. Santonin. This is decidedly the most reliable an- 
thelmintic known to the medical profession. It is deservedly 
a popular remedy for worms, and when combined with Podo- 
phyllin, is very efficacious in removing the pin-worm. Dose— 
For an adult, five to eight grains of the powdered Santonin, 
repeated every three hours until four or five doses are taken, 
when it may be followed by a cathartic. 
489. Sage (Salvia Officinalis). Sage is a common and 
excellent domestic remedy for worms. Make an infusion of 
Sage and Senna leaves, and drink freely until it acts as a 
cathartic. 322 
COMMON SENSE MEDICAL ADVISEE 
490/ Pink -Root (Spigelia Marilandica). Pink-Root is 
one of the most active and 
certain anthelmintics for 
children. It is a native of 
the United States. When 
taken in too large quanti- 
ties, it is apt to purge, give 
rise to vertigo, dimness of 
vision and even convulsions. 
Therefore it should he com- 
bined with some cathartic. 
Dose—Of the infusion, one 
ounce at night, and follow 
with physic in the morning. 
491. Common Salt 
( Chloride of Sodium). 
Common table salt is an 
anthelmintic, and may be 
used in an emergency. Salt 
water is a very common do- 
mestic remedy for worms. 
Dose — In solution, one- 
quarter to one - half tea- 
spoonful. 
492. Balmony {Che- 
lone Glabra). This is an- 
other tonic and anthelmin- 
tic, which is good in de- 
bility, dyspepsia, jaundice 
and hepatic affections. It 
is known as Snake-Head. 
Dose—Of the infusion, one 
to two ounces ; the concen- 
trated principle—Chelonin 
—from half to one grain. 
493. Male Peril (Aspidium Filix Mas). Male Fern is 
an anthelmintic, but is considered most effectual in removing the 
tape-worm. Dose—Of the powder, one to two drachms, given 
morning and evening in syrup, followed by a brisk cathartic. 
Fig. 117. 
Pink-Root. ANTIPEllIODICS. 
323 
Tincture, the buds in ether, and a dose of the tincture is eight 
to thirty drops. 
494. Poplar (Populus Tremuloides). The White or 
Aspen Poplar is a common tree and contains Populin and 
Fig. 118. 
Aspen. 
Salicin, both tonic principles. An infusion of the bark is a 
remedy for worms. Use freely a tea of the bark. Dose—Of 
Populin, from one-half to two grains. 
ANTIPERIODICS, 
495. It is well understood that malarial diseases observe a 
periodicity which at once indicates their nature. Antiperiodics 
prevent the stated recurrence of these morbid manifestations, 
and hence their name. 
496. Quinine (Sulphate of Quinia). Quinine is tonic, 
febrifuge, and antiperiodic. It should be administered during 
the remission of febrile paroxysms. Beneficial also in all dis- 
eases of debility. Dose—Varies from one to six grains, according 
to indications. Many times it is given in much larger doses; but 
I cannot advise such for domestic use. 
497. Prussian Blue (Ferri Ferrocyanuretum). Fer- 
rocyanide of Iron is an excellent tonic and antiperiodic remedy, 
and oftentimes is combined with quinine. Dose—From two to 
five grains. 324 
COMMON SENSE MEDICAL ADVISER. 
498. Roneset (Eupatorium Perfoliatum). Thoroughwort 
is tonic, diaphoretic, aperient, and possesses some antiperiodic 
Fig. 119. 
Boneset. 
properties; the warm infusion is emetic. Dose—Of the infusion, 
one to four ounces; fluid extract, from half to one teaspoonful; 
of the active principle—Eupatorin—one to three grains. 
499. My Golden Medical Discovery has gained an 
enviable reputation in malarial districts for the cure of ague. 
From observing its action in the cure of this and other mias- 
matic diseases, and knowing its composition, I am thoroughly 
satisfied that it contains chemical properties which neutralize 
and destroy the miasmatic or ague poison that is in the system, 
and at the same time produces a rapid excretion of the neutral- 
ized poisons. One strong proof of this is found in the fact that 
persons who are cured with it are not so liable to relapse as 
those on whom the chills are broken with Quinia or other agents. ANTISEPTICS AND DISINFECTANTS. 
325 
No bad effects are felt after an attack of ague when cured with 
the Discovery. This cannot be said of Quinia, Peruvian Bark, 
Arsenic and Mercurials, which comprise nearly the whole list of 
remedies usually resorted to by physicians for arresting ague. 
The Golden Medical Discovery not only has the merit of being a 
positive antidote for miasmatic diseases, but is pleasant to the 
taste, a matter of no small importance, especially when adminis- 
tered to children. To break the chills, the Discovery should be 
taken in doses of four teaspoonfuls three times a day, and if this 
treatment, pursued for three days, does not entirely arrest the 
chills, these doses may be repeated six times a day for the three 
succeeding days. Put in no case should more than this amount 
be given, and if the chills are not broken up, its use should then 
be discontinued for three days, when it may be commenced 
again and the same course pursued as before. 
ANTISEPTICS AND DISINFECTANTS. 
500. Antiseptics prevent, while disinfectants arrest, putrefac- 
tion. Oxygen is a natural disinfectant, but a powerful inciter of 
change. Although this element is the cause of animal and 
vegetable decay, yet this oxidation (eremacausis), is the grand 
process by which the earth, air and sea are purified. A few sub- 
stances are both antiseptic and disinfectant, e. g., heat, up to a 
temperature of 140° F. promotes putrescence,but above that point, 
is a drier or and destroys the source of infection. 
501. Aeast (Cerevisice Fermentum). Yeast is an antisep- 
tic and is effective in all diseases in which there is a threatened 
putridity. Used externally, it is often combined with elm 
bark and charcoal, and applied to ulcers, in which there is a ten- 
dency to gangrene. Dose—One to four tablespoonfuls once in 
two or three hours. 
502. Creosote (Flesh Preserver), is a powerful antiseptic. 
It is used in a solution of glycerine, oil, water or syrup. Dose— 
One to two drops, largely diluted. 
503. CarlJOlic Acid is a crystalline substance resembling 
creosote. It is an antiseptic, and is used both internally and 
externally. Dose—One-fourth to one-half drop of the melted 
crystals, very largely diluted. Externally, in solution, one to 
five grains of the crystals to one ounce of the solvent. 326 
COMMON SENSE MEDICAL ADVISER. 
504. White Vitriol (Zinci Sulphas). White vitriol is 
a valuable disinfectant, as it will arrest mortification. In solu- 
tion it is employed in ulcers and cancers and also as a gargle in 
putrid sore throat. Dose—One-half to two grains in a pill; 
solution, one to ten grains in an ounce of water. 
505. Permanganate of* Potash (Potassce Perman- 
ganas). This substance is an energetic deodorizer and disinfect- 
ant. A solution containing from one to twenty grains to an 
ounce of water is used as a lotion for foul ulcers. Pose—One- 
eighth to one-fourth of a grain. 
506. Wild Indigo (Paptisia Tinctoria). The root. This 
possesses valuable antiseptic properties. It is an excellent 
lotion for ill-conditioned ulcers, malignant sore throat, syphilitic 
opthalmia, etc. It is administered in scarlet and typhus fever, 
and in all diseases where there is a tendency to putrescence. Dose 
—Of the infusion, one-fourth to one-half ounce; of the fluid 
extract, from three to ten drops, and of Daptisin, (the concen- 
trated active principle of the plant), from one to two grains. 
ANTISPASMODICS. 
507. Antispasmodics are a class of remedies which relieve 
cramps, convulsions, spasms, etc., and are closely allied to ner- 
vines. Indeed some authors do not recognize their relative 
difference; yet all antispasmodics are not nervines, and vice 
versa. The following are a few of the most important anti- 
spasmodics: 
508. Assafetida (Assafetida Ferula). This is a power- 
ful antispasmodic. It is employed in hysteria, hypochondria, 
convulsions and spasms, when unaccompanied by inflammation. 
Dose—Of the gum or powder, from three to ten grains, usually 
administered in the form of a pill; tincture, from one-half to 
one teaspoonful. 
509. Valerian ( Valeriana Officinalis). The root. Vale- 
rian is an effective remedy in cases of irregular nervous action 
and restlessness. Dose—Infusion, (one-half ounce to a pint of 
water) one-half ounce; tincture, one-half to two tablespoonfuls; 
ammoniated tincture of valerian, from one-half to two teaspoon- 
fuls in sweetened water or milk; valerianate of ammonia, one-half 
to three grains. ANTISPASMODICS. 
510. Yeflow .1 essaBllilie (Gelseminum SempervIrens'). 
The root. This is a valuable remedy when the disease is asso- 
Fig. 120. 
Yellow Jessamine. 
dated with restlessness and a determination of the blood to 
the brain. Dose— Fluid extract, three to eight drops; of the 328 
COMMON SENSE MEDICAL ADVISER. 
eoncentrated principle—Gelsemin—one-fourth to one grain. The 
use of this drug by non-professional persons should be attended 
with great caution. 
511. Yellow liady’s Slipper (Gypripedium Pubes- 
cens). The root. This is a useful remedy in hysteria, chorea, 
and all cases of nervous irritability. Pose—Powder, fifteen to 
thirty grains; infusion, one ounce; fluid extract, fifteen to thirty 
drops; concentrated principle — Cypripedin — one-half to two 
grains. 
512. Wild Yam (Dioscorea Villosci). The root. This 
is a powerful antispasmodic, and has been successfully used in 
bilious colic, nausea, and spasm of the bowels. Dose—Infusion 
(two ounces to a pint of Avater), one to two ounces; fluid extract, 
five to fifteen drops; concentrated principle—Dioscorein—one- 
half to one grain. 
513. High Cranberry (Viburnum Opulus). The bark. 
Also known as Cramp Bark. This is a powerful antispasmodic, 
and is effective in relaxing spasms of all kinds. It is a valuable 
agent in arresting threatened abortion. Dose—Infusion, one- 
half to one ounce; fluid extract, one-half to one teaspoonful; 
concentrated principle—Viburnin — one-half to two grains. 
These doses may be increased, if necessary. 
ASTRINGENTS. 
514. Astringents are medicines which condense and coagulate 
the tissues, thereby arresting discharges. When taken into the 
mouth, they produce the sensation known as “ puckering.” They 
are used internally and locally. The term styptic, is used as a 
synonym of astringent, but is generally employed to designate 
those astringents which arrest hemorrhage (bleeding). 
515. Logwood (Ilcematoxylon Campechianum). Log- 
wood is a mild astringent, well adapted to remedy the relaxed 
condition of the bowels after cholera infantum. Dose—Pow- 
dered extract, five to ten grains; decoction, one ounce; fluid 
extract, fifteen to thirty drops.* 
516. Blackberry Root (Rufous Villosus). This astrin- 
gent. is a favorite domestic remedy in bowel affections. Dose—■ 
Infusion (bruised root), one-half to one ounce, sweetened. 329 
ASTRINGENTS. 
-‘>17. CateeSm (Acacia Catechu'). A tincture of this plant 
is a pure, powerful astringent, and is especially useful in chronic 
diarrhoea, chronic catarrh, and chronic dysentery. Dose—Pow- 
der, five to twenty grains; tincture, one-half to two tea- 
spoonfuls. 
518. Watch-Hazel (Hamamelis Virginica). Parts used 
are the leaves and bark. This is a most valuable astringent and 
Fig. 121. 
Witch-Hazel. 
exerts a specific action upon the nervous system. It arrests 
many forms of uterine hemorrhage with great promptness, is a 
valuable agent in the treatment of piles, and useful in many 
forms of chronic throat and bronchial affections. Dose—Infu- 
sion, one-fourth to one-half ounce; fluid extract, eight to fifteen 
drops; Hamamelin—concentrated principle—one-fourth to one 
grain. 330 
COMMON SENSE MEDICAL ADVISER. 
519. Craiiesbili (Geranium Maculatum). The root. 
This plant is also known as Crow-Foot, Spotted Geranium, etc., 
etc. It is a pleasant, yet powerful, astringent. Dose—Fluid 
Fig. 122 
Oranesbili. 
extract, ten to thirty drops; concentrated principle — Geranin 
one to two grains. ASTRINGENTS. 
331 
520. Hardback (Spirea Tomentosa). Spirea, or Mea- 
dow Sweet. The herb. It is a tonic and astringent, used in 
diarrhoea and cholera-infantum. Dose—Infusion, one-half to one 
ounce; fluid extract, three to six drops. 
Fiq. 12L. 
Fig. 123. 
Hardhack. 
521. Bugle-Weed (lycopus Virginicus). The plant. 
This is variously known as Water-Hoarhound and Water-Bugle, 
and is sedative and tonie, as well as astringent. It is employed 
in hemorrhages and in incipient phthisis. Dose — Infusion, 
one to two ounces; fluid extract, fifteen to twenty-five drops; 
concentrated principle—Lycopin—one-half to one grain. 
Bugle-Weed. 332 
COMMON SENSE MEDICAL ADVISER. 
522. Canada Fleabane (Frigeron Canadense). The 
leaves and flowers. This plant, variously known as Colts-Tail, 
Fig. 125. 
Canada Fleabane. 
Pride-Weed, Butter-Weed, etc., is astringent, and lias been 
efficiently employed in uterine hemorrhages. Dose—Infusion 
(two ounces of the herb to one pint of water), one to two ounces; 
oil, five to ten drops on sugar, repeated at intervals of from one 
to four hours. CARMINATIVES. 
333 
523. Tannin (Acidum Tannicum). This acid has a wide 
range of application. It is used as an astringent. Dose—One 
to five grains. 
524. Gallic Acid (Acidum Gallicum). This remedy is 
used in uterine hemorrhages, kidney affections, etc. Dose— 
Three to five grains. In acute hemorrhages, this quantity should 
be administered every half hour, until the bleeding is checked. 
CARMINATIVES. 
525. Carminatives are medicines which allay intestinal pain, 
expel wind from the stomach and bowels, and arrest or prevent 
griping caused by cathartics. They are aromatic, and, to a 
certain extent, stimulant. 
520. Anise-Seed (Pimpinella Anisum). Anise is a 
pleasant aromatic carminative, and is used in flatulent colic, etc. 
Dose—Powdered seed, ten to fifteen grains ; infusion (a tea- 
spoonful of seed to a gill of water), sweetened, may be given 
freely; oil, five to ten drops on sugar. 
527. Fennel-Seed. This is one of our most grateful 
aromatics, and is sometimes employed to modify the action of 
senna and rhubarb. Dose—Same as anise. 
528. dinger {Zingiber Officinale). Root. This is a grate- 
ful stimulant and carminative. Dose—Powder, ten to twenty 
grains ; infusion, one teaspoonful to a gill of water ; tincture, 
twenty to thirty drops; essence, ten to fifteen drops; syrup, one 
teaspoonful. 
529. Winter green ( Gaultheria Procumbens). The 
leaves. This plant possesses stimulant, aromatic and astringent 
properties. The essence of Wintergreen is carminative, and 
used in colics. Dose—Essence, one-half to one teaspoonful in 
sweetened water; oil, three to five drops on sugar. 
530. Peppermint (Mentha Piperita). The herb. Pep- 
permint is a powerful stimulant, carminative and antispasmodic. 
It is used in the treatment of spasms, colic and hysteria. Dose 
Infusion, may be used freely; essence, fifteen to thirty drops in 
sweetened warm water; oil, one to five drops on sugar. 
531. Spearmint (Mentha Viridis). The herb. The car- 
minative properties of Spearmint are inferior to Peppermint, and 334 
COMMON SENSE MEDICAL ADVISER. 
its chief employment is for its diuretic and febrifuge virtues. 
Dose—Same as that of Peppermint. 
532. Compound Extract of Smart-Weed. My 
Extract of Smart-Weed is a valuable carminative and aromatic 
stimulant, and has been employed with marked success in all 
diseases in which this class of remedies is required. 
CATHARTICS. 
533. Cathartics, or Purgatives, are medicines which act upon 
the bowels and increase the secretions and evacuations. In 
many parts of the country, these agents are known as “ purges,” 
or “ physics.” They have been variously divided and sub-divided, 
usually with reference to the energy of their operations or the 
character of the evacuations produced. 
Laxatives, or Aperients, are mild cathartics. Purgatives act 
with more energy and produce several discharges of a more 
liquid character than the former. 
Drastics are those cathartics which produce numerous evacua- 
tions accompanied by moi*e or less intestinal irritation. 
Hydragogues are those purgatives which act more powerfully 
than either of the others, and produce watery discharges. 
Cholagogues are those which act upon the liver, stimulating 
its functions. Cathartics constitute a class of remedies which 
are almost universally employed by families and physicians. 
534. Jalap (IpomoeaJalapa). The root. It is a drastic and 
even a liydragogue cathartic. Formerly it was combined with 
equal parts of calomel. From this fact it received the name of 
“ten and ten.” Dose—Powder, five to fifteen grains; fluid 
extract, ten to fifteen drops; solid extract, two to four grains; 
concentrated principle—Jalapin—one-half to two grains. 
535. Gamboge (Gambogici). A gum. Gamboge is a 
powerful drastic, hydragogue cathartic, which is apt to produce 
nausea and vomiting. It is employed in dropsy. It should 
never be given alone, but combined with milder cathartics. It 
accelerates their action while they moderate its violence. Dose 
■—Powder, one-half to two grains. This substance combined 
with aloes and sometimes with scammony, constitutes the basis 
of the numerous varieties of large cathartic pills found in the 
market. CATHARTICS. 
536. Clllver’s-Root (Leptandra Virginica). The root. 
This plant, known under the various 
names of Culver’s Physic, Black-Root, 
Tall Speedwell, Indian Physic, is a cer- 
tain cholagogue, laxative and cathartic. 
Dose—Of decoction, one to two fluid 
ounces; of fluid extract, ten to twenty 
drops; of tincture, twenty to thirty 
drops; of the concentrated active prin- 
ciple—Leptandrin—which is but feebly 
cathartic, as a laxative, two to five grains. 
537. Rllllbarb (Rheum Palma- 
tum). This is much used as a domestic 
remedy, and by the profession, for its 
laxative, tonic and astringent effects. It 
is used in bowel complaints. Dose—Of 
the powder, ten to thirty grains; tincture, 
one-half to two teaspoonfuls; fluid ex- 
tract, ten to thirty drops; solid extract, 
three to five grains; syrup, and aromatic 
syrup, an excellent remedy for children, 
one-half to one teaspoonful. 
538. Castor Oil (Oleum Ricini). 
Dose—From one to four teaspoonfuls. 
It may be disguised by rubbing it with 
an equal quantity of glycerine and add- 
ing one or two drops of oil of cinnamon 
or wTintergreen. 
539. Butternut (Juglans Cin- 
er ea). The bark. Butternut is a mild 
cathartic, which resembles rhubarb in its 
property of evacuating the bowels with- 
out irritating the alimentary canal. Dose 
—Extract, as a cathartic, five to ten 
grains; fluid extract, one-half to one tea- 
spoonful; concentrated principle—Jug- 
landin—one to three grains. As a laxative, one-half of these 
quantities is sufficient. 
540. Aloes (Aloe). The gum. This cathartic acts upon 
Fig. 126. 
Culver’s-Koot. 336 
COMMON SENSE MEDICAL ADVISER. 
the lower part of the bowels and sometimes causes piles. Though 
some late authors claim that in small doses it is a valuable rem- 
edy for piles. Dose—Powder or pill, three to ten grains; as a 
laxative, one to three grains. 
1541. Pjftsoan Salts {Magnesia Sidphas). Common name, 
“ Salts.” Much used in domestic practice. Dose—One-fourth 
to one-half ounce. 
542. ©r. Pierce’s Pleasant Purgative Pellets 
are so compounded from concentrated active principles, extracted 
from cathartic roots and herbs, as to combine in a small granule, 
scarcely larger than a mustard seed, as much cathartic power as 
is embodied in any larger pill found for sale in the drug stores. 
They are not only pleasant to take, but their operation is easy, 
producing no griping pain or other unpleasant effect. From their 
wonderful cathartic power in proportion to their size, people who 
have not tried them are apt to suppose that they are harsh or 
drastic in effect, but such is not at all the case; the different 
active medicinal principles of which they are composed are so 
harmonized and modified by one another, as to produce a 
most searching and thorough, yet gently and kindly operating 
cathartic. 
I have offered a standing reward to any chemist who, upon 
analysis, will find in them any calomel or other form of mercury, 
or any other mineral poison or injurious drug. 
Unlike other cathartics, they do not, after their operation, 
have a secondary tendency to render the bowels more costive. 
This is an important improvement. Every one who has ever 
taken pills or other cathartics for the purpose of overcoming 
constipation, knows, to his sorrow, that the secondary effect of 
all such medicines has been “to render a bad matter worse.” 
These Pellets, unlike every other cathartic, produce such a 
secondary tonic effect upon the bowels as to bring about a per- 
manently healthy action and increase their peristaltic motions. 
Hence their great value, perseveringly taken in small doses 
daily, in habitual constipation and in piles, attended and caused 
as they generally are, by torpor of the liver and costiveness. 
They act powerfully in arousing all the secretions, especially 
of the liver, relieving congestion or inflammation, and pro- 
ducing upon that organ, as well as upon the boAvels, a secondary CATHARTICS. 
337 
tonic and hence permanently beneficial effect. Being entirely 
vegetable, no particular care is required while using them. 
They operate without disturbance to the constitution, diet or 
occupation. Age does not impair them, as they are so prepared 
as to readily dissolve in the stomach, while their sugar coating 
and being enclosed in glass bottles preserve their virtues for any 
length of time in any climate, so that they are always fresh and 
reliable. This is not the case with the pills found in the drug 
stores, put up in wood or paste-board boxes that allow them to 
dry and harden until they are nearly, if not quite, insoluble in 
the stomach, or else have lost most of their virtues by long 
exposure to the atmosphere. No pains or expense will ever be 
spared to make the Pellets perfect and keep up their high 
standard of excellence. 
543. Dose—For a thorough cathartic, take from four to six, 
determining size of dose, or number of pellets, from the suscepti- 
bility of the system to the effects of cathartic medicines. If for 
a child, administer from one to three or four, according to age. 
Evening is the best time for taking them, as they do not operate 
by irritating the stomach and bowels, thus rushing through at 
railroad speed, but will take twelve, and, in rare cases, twenty- 
four hours in which to move the bowels, which they accomplish 
in a physiological manner, by being dissolved in the stomach 
and absorbed directly into the blood, when they stimulate a flow 
of bile from the liver, and arouse all the glandular secretions, 
which, being poured into the bowels, constitute their natural 
physic. In this way the blood itself, as well as the stomach and 
bowels, is purged and cleansed of its impurities, they being 
carried off in the bile and other secretions. It is a great mistake 
to suppose that all medicines that purge, act in the same manner 
and do the same amount of good. All cathartics that operate 
speedily, produce an irritation of the stomach and bowels, 
causing a flow of water and mucous into them, and running off 
from the bowels in watery discharges. They never enter the 
circulation, never act upon the liver, do not arouse the secretions 
nor purify the blood, but tend only to shock, and thus debilitate 
the system, and the patient soon finds the function of the bowels 
destroyed, and constipation resulting as the secondary effect of 
the irritation and overexcitement thus produced, Hence, Jalap 338 
COMMON SENSE MEDICAL ADVISER. 
and Senna, Aloes, Scammony, Castor Oil, Croton Oil, Gamboge, 
Elaterium or Epsom Salts, should not be taken with the idea 
that any good effect is going to be produced upon the blood, 
liver or other glands, as their mode of operating precludes such 
an effect. 
My Purgative Pellets, on the other hand, act upon the bowels, 
only by taking time to enter the blood, arouse the secretions, 
and letting these secretions, which are nature’s physic, move the 
bowels. Hence, when the bowels are moved after a dose of my 
Pellets, we may positively know that the liver and other glands 
have been aroused to action; and this belief will be confirmed 
by the laxative effect of the secretions after the operation of the 
cathartic, which can be best appreciated by those who suffer 
from constipation or piles, and have been used to taking other 
cathartics. 
After taking a cathartic dose of Pellets, if you desire to 
increase their purgative action, eat plentifully of common salt. 
The salt is also a good remedy for any slight nausea, griping, or 
other disagreeable symptoms, that are sometimes, yet very rarely, 
produced, not by the Pellets, for they are not irritating or harsh, 
but by the acrid and irritating character of the morbid matters 
dislodged by them. No such disagreeable symptoms will arise 
after taking my Pellets, unless the system is very foul, torpid 
and obstructed, as they are so compounded as to guard against 
all such unpleasant effects. 
The greatest benefit is derived in all bilious derangements, not 
by strong cathartic doses, but by small alterative ones, continued 
for several days, say one to three Pellets a day, or just enough 
to keep the bowels slightly relaxed. 
As an appetizer or promoter of digestion, take one to two 
after dinner. 
In all chronic or lingering diseases, it is of the utmost import- 
ance to keep the bowels regular, yet thorough purgation should 
be avoided, as it tends to debilitate the system by the shock 
which is thus produced. 
Small laxative doses, by their mild but continuous tonic and 
alterative action, taken daily and continued for a long time, 
is the plan that I would recommend as calculated to produce 
the most sanative results. DIAPHORETICS. 
339 
CAUSTICS. 
544. Caustics are substances that have the power of destroy- 
ing or disorganizing animal structures. By their action they 
destroy the tissue to which they are applied and form a crust, 
which is thrown off by a separation from the parts beneath. 
Their caustic property may be destroyed by dilution with other 
substances, to such an extent that they will only irritate or stimu- 
late, and not destroy. Much care is necessary in their employ- 
ment, and it is not expected that the non-professional reader will 
have much to do with them; hence I have thought it best to 
omit giving a list of these agents. 
COUNTER-IRRITANTS. 
545. Counter-irritants are substances that produce irritation 
of the part to which they are applied, varying in degree from a 
slight redness to a blister or pustule. They are applied to 
the surface with a view to produce an irritation there, which 
will relieve irritation or inflammation in some other or deeper 
seated part. They are a class of agents that I very seldom 
employ, and hence shall notice only a couple of the simplest 
ones. 
546. Mustard (Sinapis). The flower of Mustard, best 
adapted for domestic use, is employed, made into a paste, spread 
on cloth, and applied. It takes effect in a few moments; the 
length of time it remains in contact with the skin determines the 
effect produced. 
547. Morse-Radish (CochleariaArmoracia). The leaves 
are the parts used. Wilt and bind them on the part. They act 
about as energetically as mustard. 
548. Diaphoretics are medicines which promote perspiration. 
Those which occasion profuse sweating are termed Sudorijics 
The two terms indicate different degrees of the same operation. 
They constitute an important element in domestic practice, on 
account of the salutary effects that generally follow their action. 
Their operation is favored by warmth externally, and warm 
drinks, when they are not given in hot infusion. 
DIAPHORETICS. 340 
COMMON SENSE MEDICAL ADVISER. 
549. Catnip (Nepeta Cataria). A deservedly popular 
domestic remedy, always acceptable, and certain in its action. 
The warm infusion is the preferable form of administration. 
Dose—May be drank freely. 
550. Pleurisy-Root (Asclepias Taberosa). Also known 
as White-Root, Butterfly-Weed, etc. It is a valuable remedy, 
Fig. 127. 
well adapted to break up inflammations and diseases of the chest. 
Dose—Of infusion, one to two ounces; fluid extract, one-fourth 
to one-half teaspoonful; of the concentrated principle—Asclepin 
one to three grains. 
551. Saffron (Crocus Sativus). Golden Saffron. Dose 
—Of infusion (one drachm to the pint of water), one to two 
ounces. 
552. Sage (Salvia Officinalis). The warm infusion drank 
freely is a valuable domestic diaphoretic. 
Pleurisy-Root. DIAPHORETICS. 
341 
553. Virginia Snake-Root {Aristolochia Serpenta- 
ria). An efficient agent. Dose—Infusion, one to two ounces; 
Fig. 128. 
Virginia Snake-Iioot. 
tincture, one-fourth to one teaspoonful; fluid extract, one-fourth 
to one-half teaspoonful. 
554. Gillger (Zingiber Officinale). The hot infusion may- 
be sweetened and drank as freely as the stomach will bear. 
555. Dr. Pierce’s Compound Extract of 
Smart-Weed. This is unsurpassed as a diaphoretic agent, 
and is much more certain in its operation than any simple 
diaphoretic. 342 
COMMON SENSE MEDICAL ADVISEE 
556. Blay-Weed {Maruta Cotula). Also known as Wild 
Fig. 129. 
May-Flower. 
Chamomile, Dog-Fennel, etc. Not much used, though a powerful 
diaphoretic. Dose—Of infusion, one to two ounces. 
DILUENTS. 
557. Any fluid which thins the blood or holds medicine in 
solution is called a diluent. Pure water is the principal agent 
of this class. It constitutes about four-fifths of the weight of 
the blood and is the principal constituent of the bodily tissues. 
Water is necessary, not only for digestion, nutrition and all func- 
tional processes of life, but it is indispensable as a menstruum 
for medicinal substances. It is a necessary agent in depuration, 
or the process of purifying the animal economy, for it dissolves 
and holds in solution deleterious matter, which in this state may DIURETICS. 
343 
be expelled from the body. In fevers, water is useful to quench 
the thirst, promote absorption and incite the skin and kidneys 
to action. Its temperature may be varied according to require- 
ments. Diluents are the vehicles for introducing medicine into 
the system. I will briefly mention some which prove to be very 
grateful to the sick. 
Various vegetable acids and jellies may be dis- 
solved in water, as apple, current, quince, grape or cranberry. 
The juice of lemons, oranges, pine-apples 
and tamarinds is also found to be refreshing to fever 
patients. 
Sassafras-pit Is, slippery-elm flour, flax-seed 
and gum arabic make good mucilaginous drinks for 
soothing irritation of the bowels or other parts. 
Brewers’ yeast mixed .with water in proportion of from 
one-eighth to one-fourth is a stimulant and antiseptic. 
The white ashes of hickory or maple wood 
make an excellent alkaline drink in fevers, or whenever the 
system seems surcharged with acidity. 
DIURETICS, 
558. Diuretics are medicines which, by their action on the 
kidneys, increase the flow of urine. 
559. (|iteeil Of til© Meadow (.Eupatorium Purpur- 
cum). Also known as Gravel-Weed, Gravel-Root, Trumpet- 
Weed, etc. This is a most valuable diuretic. Dose—Of the 
infusion, one to three ounces; fluid extract, one-fourth to one- 
half teaspoonful; of the concentrated principle — Eupatorin 
(Purpu)—one-half to two grains. 
560. IS 111* El II (Diosma Crenata, Barosma Crenata). The 
leaves. This agent has been extensively employed, generally in 
compounds. Dose—Of infusion, (infused for two hours or more) 
one to two ounces; fluid extract one-half to one teaspoonful; 
compound fluid extract, the same; concentrated principle—Ba- 
rosmin—one to three grains. 
561. Pipsissewa (Chimaphila TJmbellata). Prince’s 
Pine. This is a tonic to the kidneys, as well as diuretic and al- 
terative—a mild, but very efficient remedy. Dose—Of decoction, 
one ounce four to six times a day; fluid extract, one-fourth to 344 
one-half teaspoonful; of the concentrated principle—Cliimaphilin 
—one to two grains. 
562. Mitrsiti - (Althea Officinalis). Used in 
COMMON SENSE MEDICAL ADVISEE. 
Fla. ISO. 
Marsh-Mallow. 
irritable conditions of the urinary organs. Dose—Infusion may 
be drank freely. 
563. Crravel-Plaiit {Epigea Repens). Also known as 
Winter-Pink, Trailing-Arbutus, Gravel-Root. The plant. Dose 
—Of decoction, one to three ounces; fluid extract, one-fourth to 
one-half teaspoonful. DIURETICS. 
345 
564. Water-Melon Seeds (Cucurbita Citrullus). 
Dose—Of infusion, the patient may drink freely until the desired 
effect is secured. 
565. Stone-Root {CollinsoniaCanadensis). Also known 
as Knot-Root, Horse-Balm, Rich-Weed, Ox-Balm, etc. This is a 
mild diuretic, slow in action, yet effective in allaying irritation 
Fig. 131. 
Stone-Roo£. 
of the bladder. The root is the part used. Dose—Of infusion, 
one to two ounces; fluid extract, five to ten drops; of the con- 
centrated principle—Collinsonin—one-half to one grain. 346 
COMMON SENSE MEDICAL ADVISER. 
566. Psampliiii Seeds (Cucurbita Pepo'). They are 
mild, unirritating, yet effective diuretics. Pose—Infusion of 
these may be drank freely. 
567. Spirits of Nitre {JEtlieris Spiritus Eitrici). 
Sweet Spirits of Nitre. Diuretic and anodyne. Pose—One- 
fourth to one-half teaspoonful, diluted in water, every two or 
three hours. 
568. Saltpetre (Potassce Nitras). Nitre. Pose—Pow- 
dered, five to ten grains. 
569. Acetate Of Potasla {Potassce Acetas). Pose— 
Ten to fifteen grains, largely diluted in water. More used for 
this purpose than the nitrate. It is a most valuable diuretic. 
emetics; 
570. These are medicines which cause vomiting and evacuation 
of the stomach. Many substances not classed as emetics are capa- 
ble of indirectly causing vomiting. When employed in cases of 
poisoning, it is desirable to empty the stomach as soon as possible 
and a full dose should be given at once. In other cases where 
their constitutional effect is desired, they are best given in small 
doses, repeated every five to fifteen minutes. Draughts of warm 
water favor their action. 
571. Ipecac (Cephcslis Ipecacuanha). In large doses 
Ipecac is emetic. In small doses, it exerts a specific influence 
upon the mucous membranes, relieves irritation and subdues in- 
flammation. In cholera infantum it is an invaluable remedy, if 
given in very small doses. By allaying irritation of the stomach 
and restoring tone and functional activity to it and the bowels, 
it gradually checks the discharges and brings about a healthy 
condition. In these cases I add from five to ten drops of the 
tincture to thirty teaspoonfuls of water, of which the dose is 
one teaspoonful every hour. As an emetic the dose is: Of pow- 
der, five to ten grains in warm water; fluid extract, ten to 
twenty drops. 
572. lioneset (Eupatorium Perfoliatum). Pose—Of the 
warm infusion or decoction, two to three ounces; fluid extract, 
one teaspoonful in hot water; concentrated principle—Eupatorin 
•—two to five grains. EMETICS. 
347 
573. Lobelia (Lobelia Inflata). Also known as Indian 
Tobacco, Emetic-Weed, Asthma-Weed, etc. The herb and seeds. 
Fig. 132. 
lobelia. 
A powerful emetic, generally given in combination with other 
agents. Dose—Of the powdered leaves, fifteen to twenty grains; 
of the infusion, one to three ounces; fluid extract, ten to fifteen 
drops. It is generally given combined with Blood-Root, Ipecac 
and Skunk-Cabbage, equal parts. Dose — Twenty grains in 
water. 348 
COMMON SENSE MEDICAL ADVISER. 
EMMENAGOGUES. 
574. Emmenagogue is a term applied to a class of medicines 
which have the power of favoring the discharge of the menses. 
I shall mention only a few of those best adapted to domestic use. 
575. Motherwort (Leonurus Cardiaca). Motherwort 
is usually given in warm infusion, in suppression of the menses 
from cold. Dose—Of the decoction, from two to three fluid 
ounces every one or two hours. 
576. Eife-Root (/Senecio Gracilis). Life-Root exerts a 
peculiar influence upon the female reproductive organs, and for 
this reason has received the name of Female Regulator. It is 
very efticacious in promoting the menstrual flow, and is a valua- 
ble agent in the treatment of female diseases. Dose—Of the 
decoction, four fluid ounces three or four times per day; of the 
fluid extract, from one-fourth to one-half teaspoonful. 
577. Pennyroyal (Iledeoma Pullgioides). Pennyroyal 
used freely in the form of a warm infusion, will promote perspi- 
ration and excite the menstrual discharge 
when recently checked. Dose — A large 
draught of the infusion should be taken at 
bed-time. The feet should be bathed in 
warm water previous to taking the infusion. 
578. Slack Cohosh (Cimicifuga 
Pacemosa). Black Cohosh, known also as 
Black Snake-Root, is an effective remedy 
in uterine difficulties. Dose — Tincture, 
twenty drops; fluid extract, ten drops. 
579. Tansy ( Tanacetum pulgare). 
Tansy is beneficial in suppressed menstrua- 
tion. Dose—Of the infusion, from one to 
four fluid ounces. 
580. Dr. Pierce’s Favorite 
Prescription is an efficient remedy 
in cases requiring a medicine to regulate 
the menstrual function. Full directions 
accompany each bottle. 
581. Dr. Pierce’s Compound Extract of 
Smart-Weed is an excellent emmenagogue. Dr. Eberle, 
Fig. 183. 
Pennyroyal. LINIMENTS. 
349 
a very celebrated medical writer, and author of a work on medi- 
cine that is very popular with the profession, says, that he has 
used the Extract of Smart-Weed in twenty cases of amenorrhoea 
(suppressed menstruation), and can affirm that “with no other 
remedy or mode of treatment have I been so successful as with 
this.” Full directions accohipany each bottle. It is sold by all 
druggists. 
EXPECTORANTS. 
582. Expectorants are medicines that modify the character of 
the secretions of the bronchial tubes, and promote their dis- 
charge. Being nauseants, their prolonged use invariably tends 
to debilitate the functions of the stomach, thus interfering 
with digestion and healthy nutrition. They also exert an unfa- 
vorable influence upon the pulmonary tissues, by increasing 
determination of blood to them, keeping up a continued state 
of excitement and endangering a breaking down of the lung 
tissues. I long ago abandoned all expectorants in the treat- 
ment of consumption, and other chronic diseases of the lungs, 
considering them productive of more injury than benefit; they 
are obsolete agents in my practice, hence I shall dismiss them 
without further consideration. 
LINIMENTS. 
583. Liniments are medicines designed for external applica- 
tion. The benefits arising from their use depend upon their 
derivative power, as well as upon the anodyne properties which 
many of them possess, rendering them efficacious in soothing 
pain. I cannot mention a more valuable sample of this class of 
agents than 
584. My Compound Extract of Smart-Weed. 
As an external application this preparation subdues inflammation 
and relieves pain. For all wounds, bruises, sprains, bee stings, 
insect and snake bites, frost bites, chilblains, caked breast, 
swollen glands, rheumatism, and, in short, for any and all ail- 
ments, whether afflicting man or beast, requiring a direct exter- 
nal application, either to allay inflammation or soothe pain, my 
Extract of Smart-Weed cannot be excelled. 350 
COMMON SENSE MEDICAL ADVISER. 
NARCOTICS. 
585. A narcotic is a remedy which, in medicinal doses, allays 
morbid sensibility, relieves pain, and produces sleep; but which, 
in overdoses, produces coma, convulsions and death. The quan- 
tity necessary to produce these results varies with different 
individuals. We shall mention a few of those most generally 
employed. 
586. Heilbitne (Ilyoscyamus Niger). Leaves and seeds. 
Henbane, in large doses, is a powerful narcotic and dangerously 
poisonous. In medicinal doses, it is ano'dyne and antispasmodic; 
Fig. 13Jh 
it allays pain, induces sleep, and arrests spasms. Dose—Of the 
fluid extract, five to ten drops; of the solid extract, from one- 
half to one grain ; of the concentrated principle—Hyoscyamin— 
from one-twelfth to one-fourth of a grain. 
Henbane. NERVINES. 
351 
587. Indian Hemp (Cannabis Indica). East Indian 
plant. Dose—Of the extract, from one-fourth to one-half grain; 
tincture, from three to eight drops ; fluid extract, from two to 
five drops. The plant known as Indian Hemp, growing in this 
country, possesses very different qualities. 
588. Stramonium {Datura Stramonium). Stramonium, 
also known as Thorn-Apple, in large doses is a powerful narcotic 
Fig. 135. 
Stramonium. 
poison. In medicinal doses it acts as an anodyne and antispas- 
modic. Dose—Of extract of leaves, from one-half to one grain; 
fluid extract, from three to six drops. 
NERVINES. 
589. These are medicines that act on the nervous system, 
soothing excitement and quieting the condition known as 
“ nervousness.” 352 
COMMON SENSE MEDICAL ADVISER. 
590. Hops [Ilmnulus Lupulus). Dose—Of infusion, one 
to three ounces; fluid extract, one-fourth to one-half teaspoonful; 
of the concentrated principle—Lupulin—two to three grains. 
591. Fady’s Slipper (Cypripedium Pubeseens). The 
root. Dose—Infusion, one-half to one ounce; fluid extract, one- 
fourth to one-half teaspoonful; of the concentrated principle— 
Cypripedin—one to two grains. 
592. Scull-Cap {ScutellariaLateriflora). The herb. Also 
known as Mad Dog-Weed, etc. This is a valuable remedy. 
Lose—Of infusion, one to 
two ounces; fluid extract, 
ten to twenty drops; con- 
centrated principle — Scu 
tellarin—one to two gi’ains. 
593. Pulsatilla 
{Pulsatilla Nigricans). 1 
employ the Genman tinc- 
ture, prepared according to 
the Homoeopathic pharma- 
cy from the green herb. 
In many of the distressing 
nervous symptoms to which 
both males and females are 
subject in certain forms of 
disease of the generative 
organs, I find it to give 
prompt relief. I usually 
direct one drachm of the 
tincture, to be diluted with 
four ounces of water, of 
which the dose is one tea- 
spoonful. 
594. Dr. Pierce’s Favorite Prescription. This 
is a tonic nervine of unsurpassed efficacy, combined in such a 
manner, that while it quiets nervous irritation, it strengthens the 
enfeebled nervous system, restoring it to healthful vigor. In 
all diseases involving the female reproductive organs, with which 
there is usually associated an irritable condition of the nervous 
Fig. 136 
Scull-Cap. SEDATIVES. 
353 
system, it is unsurpassed as a remedy. It is also a uterine and 
general tonic of great excellence. It is sold by all druggists. 
SEDATIVES, 
595. Sedatives are a class of agents that control excitation of 
the circulation and morbid irritability of the nervous system. 
596. Aconite (Aconitum Napettus). Parts used—root 
and leaves. Dr. Scudder says: “Aconite is a stimulant to the 
sympathetic system of nerves, 
and increases the power of the 
heart to move the blood, at the 
same time that it places the 
blood-vessels in better condition 
for its passage. To fully indicate 
the plausibility of this theory, I 
would call attention to the fact, 
that the action of the heart and 
the circulation of the blood, not 
only in the arteries and veins, but 
also in the capillaries, is under 
the control of the sympathetic 
system of nerves.” The same 
author says: “Aconite, in small 
doses, lessens the frequency of 
the pulse, because it removes 
obstruction to the free flow of 
blood in the vessels, and gives 
greater cardiac power. Aconite 
is indicated, in preference to Ver- 
atrum, when the pulse is weak, 
compressible and frequent, indeed 
whenever thei*e is evidence of 
great enfeeblement of the circu- 
lation.” Veratrum is especially 
indicated in preference to Aco- 
nite whenever the pulse is, not 
only frequent, but strong, full, hard or bounding. Dose—The 
tincture or fluid extract may be given in the same manner, and 
Fig. 137. 354 
COMMON SENSE MEDICAL ADVISER. 
in the same sized doses as directed for Veratrum, with the best 
results. 
597. American Hellebore ( VeratrumViride). Also 
known as White Hellebore, Indian Poke, Swamp Hellebore. The 
Fig. 138. 
American Hellebore. 
root is the part used. It is a most valuable agent with which to 
control the frequent, strong, bounding pulse common to many STIMULANTS. 
355 
febrile and inflammatory diseases. This remedy should be given 
in very small doses, frequently repeated, if we would secure its 
best effects. My favorite mode of administering it is to add ten 
drops of the fluid extract to ten or fifteen teaspoonfuls of water, 
of which one teaspoonful is administered every houi\ The 
tincture may be given in one-half lai'ger doses. In addition to 
its controlling influence over the circulatory organs, it is one of 
the most certain alteratives in the Materia Medica, bxxt must, to 
secure this effect, be administered in doses of only one-half to one 
drop of the fluid extract three or four times a day. 
598. Yellow •Fessaifiline (Gelseminurn Semper virens). 
The root is the part used. Through its controlling effect over 
the sympathetic nervous system, this agent exerts a marked 
influence in controlling morbid excitability of the circulatory 
organs. It allays irritation, and determination of blood to the 
bx*ain, marked by flushed face, contracted pupils, irritability and 
restlessness—a frequent condition in diseases incident to child- 
hood. Its concenti’ated principle—Gelsemin—is a specific i*emedy 
in bloody-flux or dysentery. It must, howevei', be administered 
in very small doses, in order to secui-e the best results. Only one- 
sixteenth to one-eighth grain is required, to be repeated evexy 
two houi-s. It should be triturated with sugar of milk or with 
common white sugar, in proportion of one grain to ten of sxxgar. 
Pose—Of tincture, from five to fifteen drops; of fluid extract, 
thi*ee to six drops; Gelsemin, as a sedative, one-foxxi-th to one- 
half grain. 
699. Peach Tree (Amygdalus Persicd). Peach tree 
leaves and bark are slightly sedative, but the chief use that I 
have found for these articles is to control nausea and vomiting 
arising from irritability of the stomach. For this purpose it 
surpasses all other remedies with which I am acquainted. It 
also possesses mild tonic properties. Pose—Of infusion of the 
bark of the small twigs or of the leaves, from two to six 
teaspoonfuls. 
600. Stimulants are medicines which have the power of 
exciting the organic action of the different systems of the 
bodily economy. Some have a temporary action, while others 
are more permanent in effect. 
STIMULANTS. 356 
COMMON SENSE MEDICAL ADVISER. 
601. Cayenne Pepper {Capsicum Annuum). Cayenne 
Pepper is a powerful stimulant. Dose—Of the powder, from 
one to six grains, to be given in milk; of the tincture, from five 
to ten drops largely diluted in milk or water. 
602. Prickly-AsSl (JCanthoxylum Fraxineum). Prickly- 
Ash bark is a stimulant and tonic. Parts used—bark and leaves. 
Dose—Fluid extract, from five 
to fifteen drops ; tincture, ten 
to twenty drops; of the active 
principle — Xanthoxylin — one 
to two grains. 
603. ISlack Pepper 
(Piper Nigrum). Black Pep- 
per is a warm carminative stim- 
ulant. Dose — From five to 
fifteen grains; fluid extract, 
from ten to fifteen drops. 
604. AlcoHol is a power- 
ful stimulant. It is never used 
in its pure state in medicine, 
but when diluted forms a useful 
remedy in many diseases. It is 
generally employed in the form 
of whisky, gin, rum, brandy and 
wine. 
605. Ammonia is large- 
ly used as a stimulant. Dose 
•—Of the carbonate, from three 
to five grains; of the sesquicar- 
bonate, from five to ten grains; 
this is the same as the carbo- 
nate, which has been exposed 
to the air and slacked (powdered 
hartshorn); of the aromatic 
spirit, from one-half to one teaspoonful. The Aqua Ammonia 
and Liquor Ammonia are of such variable strength that they are 
seldom employed internally, but may be applied externally and 
to the nostrils. 
Fig. 139. 
Trickly-Ash, TONICS. 
606. Dr. Pierce’s Compound Extract of 
Smart-Weed. This quickly diffusible stimulant and genial 
anodyne we have spoken of under the head of Anodynes. But 
its medicinal properties equally entitle it to a place and mention 
under the class of stimulants. Sometimes the circulation of the 
blood flags, and, instead of being carried to the surface of the 
body, it recedes to the bowels, liver or lungs, producing con- 
gestion, with a sense of fullness and of pain. A stimulant 
spurs the nervous energies and arouses the circulatory forces. 
Congestion of the lungs, liver, bowels or uterus, embarrasses 
their functions. Oftentimes this congestive difficulty may be 
entirely obviated, and the circulation of the blood restored to 
the surface of the body, by a few doses of this pleasant remedy. 
Thus it may act like magic in giving desired relief, promoting 
the circulation and restoring the organs to their accustomed 
functional activity. Full directions accompany each bottle. 
TONICS. 
607. Tonics are remedies which moderately and permanently 
exalt the energies of all parts of the body, without causing any 
deviation of healthy function. 
608. White Poplar (Liriodendron Tulip*fera). Called 
also American Poplar, White Wood, etc. 
Part used—the inner bark. This is a mild 
but valuable tonic for domestic use. Dose 
—Of the infusion, from one-half to one 
ounce; of tincture, from one to two tea- 
spoonfuls. 
609. Chamomile (Anthemis JSTo- 
hilis). Part used—the flowers. This is a 
mild, unirritating tonic. Dose—Of infu- 
sion, (one-fourth ounce of flowers to a pint 
of water), one-half to one ounce. 
610. Gentian (Gentiana lutea). 
The root. This is a favorite domestic 
tonic in many sections. Dose—Of pow- 
dered root, five to ten grains; of the 
tincture, ten to twenty drops; of the fluid 
extract, five to ten drops, four or five times 
Fig. 1)0. 
White Poplar. 358 
COMMON SENSE MEDICAL ADVISER. 
a day; of the active principle—Salicin—from two to four grains, 
three or four times a day. 
611. Dogwood Florida). Dogwood, also known 
as Boxwood, is tonic, astringent, and slightly stimulant. Dose—• 
Fig. lJfl. 
Of the solid extract, from three to five grains; of the infusion, 
from one to two ounces; of the fluid extract, from ten to twenty 
drops. 
Dogwood. 
612. IVllX Yoniica {Strychnos Nux Vomica). Dog But- 
ton. This is a powerful tonic. It increases innervation and is 
particularly valuable in cases marked by feeble circulation and 
general impairment of muscular power. In overdoses it is 
poisonous, and hence must be employed with much caution. 
Dose—Tincture, three to five drops; fluid extract, one to three 
drops. TOXICS. 
359 
613. Golden Seal (Hydrastis Canadensis). Golden Seal 
is a powerful and most valuable tonic. Dose—Of the powder, 
Fig. 1J$. 
Golden Seal. 
from ten to thirty grains; of the tincture, from one-half to one 
fluid drachm; of the fluid extract, from ten to twenty drops; of 
the concentrated principle—Hydrastin—from two to three 
grains; of the muriate of liydrastia, from one-half to one grain. 
614. Willow (Salix Alba). Willow is a tonic and an as- 
tringent. Dose—Of the decoction, from one to two fluid ounces. 360 
COMMON SENSE MEDICAL ADVISER. 
615. American Colombo (FraserCl Carolinensis). 
American Colombo is a simple tonic, Dose-—Of the powdered 
Fig. US. 
American Colombo. 
root, from ten to fifteen grains; of the infusion one-half to one 
fluid ounce, three or four times a day; of the active principle— 
Fraserin—one to three grains. TONICS. 
361 
616. Gold Thread (Coptis Trifolid). Gold Thread is 
a pure and powerful bitter tonic, and is also efficacious as a wash 
Fig. 1U- 
for the mouth or a gargle. Dose—Of the decoction, from two to 
six fluid drachms; of the tincture, from one-half to two tea- 
spoonfuls; of fluid extract, from ten to twenty drops. 
617. Wafer-Ash (Ptelea Trifoliata). Also called Swamp 
Dogwood, etc. The bark. This is a pure, unirritating tonic. 
Dose—Of tincture, one-half to one teaspoonful; of fluid extract, 
ten to twenty drops; infusion, one to two fluid ounces. 
618. Iron (Ferrum). Different preparations of iron are 
largely prescribed by physicians, and they have been classed as 
tonics. They are particularly valuable in anremic (bloodless) 
conditions of the system. The following are a few of the pre- 
parations of this metal most generally used: 
Iron by Hydrogen. (Ferri Redactum). Dose—One to 
two grains. 
Carbonate Of Iron. {Ferri Carbonas). Dose—One 
to three grains. 
Gold Thread. 362 
COMMON SENSE MEDICAL ADVISER. 
Citrate Of Iron (Ferri Citras). Dose—One to three 
grains. 
Pyrophosphate of Iron {Ferri Pyrophosphas). Dose 
—One to three grains. 
Muriated Tincture of Iron (Tinctura Ferri 
Chloridi). Dose—Three to six drops. 
619. Dr. Pierce’s Favorite Prescription. The 
Favorite Prescription, in addition to those properties already 
described, likewise combines tonic, properties. In consequence 
of the never ceasing activities of the bodily organs, the system 
requires support, something to permanently exalt its actions. In 
all cases of debility, this Favorite Prescription tranquilizes the 
nerves*, tones the organs and increases their vigor, and strength- 
ens the system. Directions for use accompany each bottle. 
620. My Golden Medical Discovery. In addi- 
tion to the alterative properties combined in this compound, 
it possesses important tonic qualities. While the Favorite 
Prescription exerts a tonic influence upon the digestive and 
nutritive functions, the Golden Medical Discovery acts upon 
the emunctories. Besides, it tends to diminish unusual waste 
and expenditure, by its antiseptic and restraining influences. 
This latter remedy tones, sustains and at the same time 
regulates the functions. And while increasing the discharge of 
noxious elements accumulating in the system, it promptly arrests 
the wastes arising from debility, and the unusual breaking down 
of the cells as witnessed in quick decline. Its alterative prop- 
erties act upon the glands, causing the torpid liver to secrete, 
changing the sallow complexion and transforming the listless in- 
valid into a vigorous and healthy being. At the same time, it 
checks the rapid disorganization of the tissues and their 
putrescent change, while it sustains the vital processes. It is 
therefore an indispensable remedy in the treatment of many 
diseases. CHAPTER III. 
WATER AS A REMEDIAL 
AGENT. 
621. The remedial effects of bathing are generally underrated. 
This non-appreciation is oftener due to the improper manner in 
which it is performed than to an insufficiency of curative virtues. 
The term bathing, not only implies a cleansing of the body or 
certain portions of it, but also the application of water in such a 
manner as to influence the nervous system, and regulate the 
functions of the secretory organs. Cleanliness, while it preserves 
health and promotes recovery, considers only the hygienic influ- 
ences of water, and overlooks its curative effects. There are 
several kinds of baths, the names of which indicate their char- 
acter, manner of application, or the part of the body to which 
they are applied. Among others, we have Cold, Cool, Tem- 
perate, Tepid, Warm, Hot, Hot Air, Russian, Turkish, Vapor, 
Electric, Sea, Shower, Sponge, Douche, Foot, Sitz, Head, Med- 
icated, Alkaline, Acid, Iodine and Sulphur Baths. Temperature 
influences the properties of any bath; thus the sponge, sitz and 
alkaline baths may be employed warm or cold, according to the 
effect desired. 
622. The Cold Bath, used at a temperature of from 
30° to 60° F., is powerfully sedative, and employed for its tonic 
effects. If the vital powers are low, or the individual remains 
in it too long (two or three minutes should be the limit), the 
reaction will be slow and its effects injurious. While it is highly 
invigorating to robust persons, its employment by those who 
have a low standard of vitality should be cautious. A local 
employment may be followed by beneficial results, when its 364 
COMMON SENSE MEDICAL ADVISER. 
general application would be inadmissible. For these reasons 
we advise the general use of the 
623. Cool Bath, at a temperature of from 60° to 75° F. 
If, in any instance, the reaction is slow, we recommend the 
624. Temperate Bath, at a temperature of from 75° to 
80° F. The time of remaining in the bath must be regulated by 
the strength of the invalid. As a rule it should not exceed three 
minutes, and the colder the water the less time should the patient 
be immersed. Immediately after emerging from any bath, the 
body should be thoroughly dried, and rubbed with a moderately 
coarse towel until a glow is experienced and reaction is fully 
established. The attempt to toughen children by exposing them 
to low temperatures of either air or water, cannot be too emphati- 
cally condemned. This caution, however, does not apply to the 
employment of moderately cool water for ablutions. The cold 
or cool bath should be taken in the eai’ly part of the day, but 
never during digestion. Whenever reaction does not follow 
bathing, artificial means must be resorted to, as stimulating 
drinks, dry warmth or exercise. 
625. Tlie Tepid Bath, the temperature of which is 
from 85° to 92° F., is generally used for cleansing the body. It 
is prescribed in fevers and inflammatory affections for its cooling 
effects. It is usually medicated with some acid or alkali. The 
latter unites with the oily secretion of the skin and forms a soapy 
compound easily removed by the water. The temperature should 
be regulated according to the vitality of the patient, and the both 
may be repeated two or three times a day. It removes superfluous 
heat, and keeps the skin in a good condition for excretion. 
626. The Warm Batll9 at a temperature varying from 
92° to 98° F., is always agreeable and refreshing. It equalizes 
the circulation and softens the skin, by removing all impurities. 
It moderates pain and soothes the whole system. It does not 
weaken or debilitate the person, but is in every way beneficial. It 
is an efficient remedial agent in many chronic diseases, convul- 
sions, spasmodic affections of the bowels, rupture, rheumatism, and 
derangement of the urino-genital organs. It should be employed 
immediately before retiring, unless urgent symptoms demand it 
at other times. It may be medicated or not, as circumstances 
require, but should always be taken in a warm room. BATHS. 
365 
627. The Bot Bath at a temperature of from 98° to 110° 
F. is a powerful stimulant. It excites the nerves, and through them 
the entire system. It causes a sense of heat and a constriction 
of the secretory organs; but perspiration, languor and torpor, 
soon follow. In the sudden retrocession of cutaneous diseases, 
it restores the eruptions to the surface and insures speedy relief. 
The hot bath may be applied locally when circumstances require. 
628. The Russian Bath consists in the application 
of hot vapor, at a temperature varying from 112° to 200° F. 
The patient is first subjected to a moderately warm temperature, 
which is gradually increased as he becomes inured to it, the head 
being surrounded with cloths wet in cold water. Upon emerging 
from it, the bather is plunged into cold water or receives a cool 
shower bath. 
In rheumatic and cutaneous diseases, chronic inflammations 
and nervous affections, the Russian bath is an effective remedy, 
and unless the patient has some malady contra-indicating its 
employment, it neither produces weakness nor predisposes the 
system to attacks of cold. Indeed, in Russia, these practices are 
not only pleasurable, but strengthen the constitution, thus ena- 
bling the inhabitants to endure the extreme cold to which their 
climate subjects them. The hot vapor causes a sense of pressure, 
which is soon followed by a profuse perspiration. It instanta- 
neously affects the perspiratory glands, increasing their activity, 
and thereby eliminating the broken-down tissue cells and noxious 
matter. 
629. The Turkish Bath is a dry, hot-air hath. The 
bather passes from one apartment to another, each one being of 
a higher temperature than the preceding. He undergoes a 
thorough shampooing, and although the person may be scrupu- 
lously neat he will be astonished at the amount of effete matter 
removed by this process. The bather then returns through the 
various apartments, and upon emerging from that of the lowest 
temperature, he experiences a delightful sensation of vigor 
and elasticity. The duration of the bath is optional. In Oriental 
countries, it is from fifteen to twenty minutes, and is often 
increased to as many hours. Persons having the management 
of Russian and Turkish baths are expected to instruct bathers 
in the necessary precautions against exposure to c’old. 366 
COMMON SENSE MEDICAL ADVISEE. 
630. The Spirit Vapor Bath is ail excellent substi- 
tute for the Russian or Turkish bath, and is very effective when 
employed in the earlier stages of acute, febrile, inflammatory 
and painful diseases. In many forms of chronic disease the 
administration of a spirit vapor bath once in from three to fifteen 
days, is an invaluable adjunct to the treatment of these affec- 
tions. It exerts an exceedingly beneficial influence upon the en- 
tire system, and when habitually employed, will ward off 
disease. 
The body should be moistened with an alkaline solution be- 
fore entering the spirit vapor bath. After the perspiration, 
which it occasions, has subsided, which will usually be in from 
three to four hours, sponge the body with a mixture of the fol- 
lowing ingredients, viz.: Water, three gills; Alcohol, one gill; 
Salt, one tablespoonful. By this method the patient experiences 
none of the unpleasant effects which generally follow the em- 
ployment of diaphoretics or sudorifics. Various kinds of ap- 
paratus have been devised to facilitate the application of the 
spirit vapor baths. Most of them are cumbersome and expen- 
sive, and consequently are seldom used except in hospitals or 
infirmaries. 
The following method which I find in a work entitled 
“Chronic Diseases,” by John King, M. D., may be advanta- 
geously employed. 
631. “The patient is undressed, ready for getting into bed, 
having removed the clothing worn through the day and put on a 
night shirt or other clothing to be worn while sweating, and du- 
ring the night, if the bath is taken at bed-time. He is then seated 
on a high Windsor or wooden-bottomed chair, or instead thereof, 
a bench or board may be placed on a common open-bottomed 
chair, care being taken that the bottom is so covered that the 
flame will not burn him. After seating himself, a large coverlid 
or blanket is thrown around him from behind, covering the back 
of his head and body, as well as the chair, and another must be 
passed around him in front, which last is to be pinned at the 
neck, loosely, so that he can raise it and cover his face, or remove 
it doAvn from the face from time to time as occasion demands 
during the operation of the bath. The blankets must reach 
down to the floor and cover each other at the side, so as to BATHS. 
retain the vapor. This having been done, a saucer or tin vessel, 
into which is put one or two tablespoonfuls of whisky, brandy, 
alcohol or any liquor that will burn, is then placed upon the 
floor, directly under the center of the bottom of the chair, 
raising a part of the blankets from behind to place it there. 
Then light a piece of paper, apply the flame to the liquor and 
as soon as it kindles let down the part of the blanket which has 
been raised, and allow the liquor to burn until it is consumed, 
watching it from time to time to see that the blankets are not 
burned. As soon as consumed, put more liquor into the saucer, 
about as much as before, and again set it on fire,—being careful 
to put no liquor into the saucer while the flame exists, as there 
would be danger of setting fire to the blanket, and producing 
injury to the patient. Continue this till the patient perspires 
freely, which, in a majority of cases, will be in five or ten 
minutes.” 
“If, during the operation, the patient feels faint or thirsty, cold 
water must be sprinkled or dashed in his face, or he may drink 
one or two swallows of it,—and in some cases the head may be 
bathed with cold water. As soon as free perspiration is pro- 
duced, wrap the blankets around him, place him in bed and 
cover him up warm, giving him about a pint of either some good 
store tea, ginger, or some diaphoretic herb tea to drink, as warm 
as he can take it. After two or three hours, remove the cover- 
ing, piece by piece, at intervals of twenty or twenty-five minutes 
each, that he may gradually cease perspiring.” 
The above method may be improved by using an ordinary 
hoop skirt, ten or twelve inches below the bottom of which is 
suspended a larger and stronger hoop. The upper and smaller 
hoops should rest upon the patient’s shoulders. A woolen 
blanket, large enough to reach and rest upon the floor, and 
envelop the whole person, is thrown over the hoops. Unless 
the bath is employed to diminish the quantity of fluids in 
the body (as in dropsy), the patient may drink some simple dia- 
phoretic infusion, to hasten or facilitate perspiration. When he 
perspires freely, small quantities of cold water may be frequently 
given. “ There is little or no danger of taking cold after this 
process, if ordinary precaution is observed, and it is easy, agree- 
able, safe and effectual.” COMMON SENSE MEDICAL ADVISER. 
632. “ Occasionally we will meet with patients, upon whom it 
is almost impossible to produce the slightest moisture, much less 
perspiration. The skin of such persons is generally dry and 
harsh, communicating an unpleasant sensation to the touch. In 
most instances the skin may be restored to its normal condition, 
by adopting the following course: 1st. Anoint the whole sur- 
face of the body and limbs every night upon retiring to bed. 
2d. Every morning wash the whole surface with a warm, weak 
alkaline solution, employing considerable friction while drying. 
3d. Every two weeks administer a spirit vapor bath. Perse- 
verance in this course for a few months will accomplish the 
desired result.”—(“ Chronic Diseases ”—King.) 
This bath is a useful remedy in Bright’s disease of the kidneys. 
Frequent reference to spirit vapor baths willl be made by the 
author of this work, in speaking of those diseases in which 
its employment will prove beneficial. 
633. A Vapor Batll may be improvised, although it is 
not as effectual as the spirit vapor bath. Connect a tube with 
some close vessel in which water is boiling, and carry the other 
end of the tubing under a chair upon which the patient sits, pre- 
pared as before. The hot steam escapes through the tubing and 
envelops the whole body. It may be medicated or not, as 
desired. When the patient is unable to be removed from the 
bed, the steam may be conducted into the bed. The clothes 
should be raised and supported upon hoops, forming a sufficiently 
large space to retain the vapor. 
634. Electric and Magnetic Baths are quite ex- 
tensively employed, and are attended with beneficial results, when 
properly adapted to the condition of the patient. The electro- 
positive, increases, and the electro-negative bath diminishes, vital 
forces. 
To give an electro-positive bath, the electricity which accumu- 
lates upon the glass must be collected, while the negative 
electricity, with which the rubbers are charged, should be dis- 
posed of as rapidly as it is generated. To effect this end, a 
metallic chain, communicating with the ground, must be attached 
to the rubbers, between which the glass plate revolves. The 
patient is placed upon an insulated stool, which may be impro- 
vised by placing pieces of glass under the feet of a chair. Glass BATHS. 
being a non-conductor, there is no communication with the floor 
or ground. He is required to hold the prime conductor of the 
electric machine. When the glass plate is revolved, the body of 
the patient becomes charged with positive electricity, while the 
surrounding air is negative. 
For an electro-negative bath, this process is exactly reversed. 
635. Tile Galvanic Bath is employed for similar 
porposes, and is prepared by placing the patient in a hath tub 
(the inside of which is painted, or otherwise insulated), filled 
with water containing any drug deemed necessary. A wire 
connected with the positive pole, and having a sponge attached 
to it, communicates with the body. The negative pole is sus- 
pended in the water. The galvanic current from the positive 
pole, fills the body and escapes through the pores. A Pulver- 
macher chain is usually employed as a conductor, and no shock 
is experienced, except when it is first applied to the body. “A 
genial glow soon appears, and an exhileration of spirits; the 
secretions are freed, and tone, sooner or later, according to the 
case, is the result.” 
636. Sea Bathing is an excellent remedial agent in 
chronic disorders, particularly those of an atonic character, 
which are attended with a deprivation of the vital fluids and an 
irritation of the nervous system. 
Much of the benefit attributed to this mode of bathing is 
undoubtedly due to other influences, such as pure air, exercise, 
change of scenery, diet and new associations which surround 
the patient during his sojourn at the sea-shore. 
At first, the duration of a sea-bath should not exceed three to 
five minutes, but may be gradually prolonged to fifteen or 
twenty minutes. If the patient is very feeble, one or two baths 
a week are sufficient, and the most robust person should never 
take more than one a day. They should always be taken in 
the earlier portion of the day, before breakfast is preferable, 
and never during digestion. 
Before entering this bath, a moderate degree of exercise 
should be taken, enough to arouse the vital energies, but not to 
produce fatigue. Suitably dressed, the patient plunges into the 
water, in which he remains during the prescribed time. He 
should maintain an upright position, to receive the stimulating 370 
COMMON SENSE MEDICAL ADVISER. 
infiuence imparted by the motion of the waves. Immediately 
after emerging from the bath, the patient should be thoroughly 
dried, dressed again and moderate exercise taken to induce 
reaction. If the reaction is slow, a mild stimulant may be taken 
and the duration of the bath must be diminished next time. 
When sea-bathing is beneficial, improvement is soon manifested. 
The blood becomes richer, the whole system is revitalized and 
the functions are performed with more regularity. To the rich, 
sea-bathing is a luxury, but it is a remedy denied to the poorer 
classes unless they live near the sea-shore. 
637. The Shower Bath produces a shock to the ner- 
vous system by its concussion with the skin. Numerous streams 
of cold water fall upon the neck, shoulders and body of the 
patient who stands beneath the hose or reservoir. When the 
patient is plethoric, feeble or nervous, or when some internal 
organ is diseased, the cold shower bath should not be employed. 
In simple debility, unaccompanied by inflammation or symptoms 
of internal congestion, its use will prove advantageous. By 
moderating the force of the shower, and substituting tepid 
water, the most delicate persons can endure it and profit 
thereby. The usual means for inducing a good reaction 
should be employed, viz., friction and exercise. 
638. The Douche Bath consists of a stream of water, 
dashed or thrown upon the patient from a moderate height or 
distance, with considerable force. The size, temperature and 
force of the stream may be modified to suit the exigencies of 
the case. It is locally employed as a remedy for sprains, weak 
or stiff joints, old swellings, etc., etc. The cold douche 
bath is more powerful than the shower bath and should be 
attended with the same precautions that govern the application 
of the latter. 
639. The Sponge Bath admits of extensive employ- 
ment in both acute and chronic diseases, and its simplicity 
renders it of untold value. It consists in a general or local 
application of water (medicated or not) at any desired tempera- 
ture. The quantity may be great or small to suit the exigencies 
of the case. If it is applied in acute diseases at a temperature 
agreeable to the patient, it is exceedingly grateful and may be 
repeated as often as necessary. It may be rendered alkaline by BATHS, 
371 
the addition of some compound of soda, in the proportion of a 
teaspoonful to a quart of water. A portion of the body may be 
bathed at a time, and quickly dried, thus avoiding any exposure 
to cold. It removes excessive animal heat, relaxes the capil- 
laries, equalizes the circulation and produces comfort, tranquility 
and sleep. Its temperature is generally the same as that of the 
tepid bath (see 1~625). 
640. The Foot Bath, technically termed pediluvium, 
is frequently employed as a means of causing diaphoresis, in 
colds, attacks of acute diseases, and also as a derivative * when 
there is a determination of blood to the head or some in- 
ternal organ. It is a powerful auxiliary in the treatment of 
those chronic diseases, of which inflammation, congestion and 
feeble circulation are prominent symptoms. A bucket, pail or 
any vessel of a similar form, will be suitable for its application. 
The water should be as hot as it can be borne, and the tempera- 
ture kept up by additions of hot water. It may be made stimu- 
lating by the addition of salt, mustard, ginger, cayenne pepper, 
etc., etc. 
641. The Sit* Bath. A tub is so arranged that the 
patient can sit down in it while bathing. In this manner the 
lower part of the abdomen, hips and upper part of the thighs, 
are immersed in whatever fluid the bath is composed of. It is 
applicable in diseases of the pelvic organs, and may be hot, 
warm, cool, cold or medicated, according to the effect desired. 
The bath tub should be large enough to permit a thorough 
rubbing and kneading of the diseased parts, and the patient may 
remain in it from ten to thirty minutes. The clothing may be 
wholly or partially removed, as agreeable to the individual. A 
warm sitz bath is an effective remedial adjunct in suppression or 
painful menstruation, gravel, spasmodic and acute inflammatory 
affections generally. The cold sitz bath is used as a tonic in 
cases of relaxed tissues of the pelvis, feeble condition of the 
urino-genital organs, piles, prolapsus of the rectum, constipa- 
tion, etc. 
642. The Head Bath. A shallow basin contains the 
fluid for the bath; and the patient, assuming a recumbent 
* A derivative is a remedy which, by producing a modified action in some organ 
or texture, derives irom the morbid condition of some other organ or texture. COMMON SENSE MEDICAL ADVISER. 
position, immerses a portion of the head — generally the back 
part. The temperature may be warm, cool, or cold, as desired. 
643. Medicated Baths are infusions of vegetable or 
other substances in water. They are sometimes applied with 
the sponge, though generally the patient is immersed. The 
temperature at which they are usually employed is that of the 
tepid bath (see 625). The nature and strength of the medica- 
ment depends upon the character of the disease for which it is 
employed. 
644. The Alkaline Bath is prepared by dissolving 
half a pound of Carbonate of soda in sixty gallons of water. It 
is useful in those diseases in which the fluids of the body are 
acidified. Rheumatism is a disease of this character. 
645. The Acid Bath is prepared by adding two pounds 
of Muriatic acid to sixty gallons of water. A much smaller 
quantity of the acid sometimes is used, and in some instances 
vinegar is substituted. 
Scott's Acid Batli is composed of Nitro-muriatic acid (aqua 
regia) and water. It should be prepared in a wooden tub, 
and a sufficient quantity of acid used to make the water taste 
sour. It is extensively used in India as a remedy for disorders 
of the liver. 
646. The Iodine Bath is composed of the following 
ingredients, viz: Iodine, two drachms; Iodide of Potassium, 
four drachms; Water, forty gallons. It should he prepared in a 
wooden tub. It reddens the skin. For children, a much weaker 
solution must be employed. The Iodine vapor bath may be 
administered in the same manner as the Spirit Vapor bath (see 
630). Its use is generally restricted to scrofulous and tuber- 
cular affections. 
647. The Sulphur Bath is prepared by dissolving 
eight ounces of Sulphuret of Potassium and two ounces of dilute 
Sulphuric acid in sixty gallons of water. The acid may be 
omitted. 
648. A Sulphur Vapor Bath is often employed in 
cities where the necessary apparatus can be procured. It may 
he improvised by placing sulphur on a shovel over hot coals. 
The patient should be prepared as in the spirit vapor bath, and WET SHEET PACK. 
373 
burning sulphur substituted for the liquor. The patient is 
then enveloped in the fumes of sulphurous oxide. Heating a 
mixture of sulphur and sulphuric acid, produces the same result. 
If the gas is inhaled in large quantities (sulphurous oxide), it 
causes irritation of the respiratoiy passages, and suffocation. It 
is therefore necessary that the coverings should be securely 
fastened at the neck, and the room be one that can be quickly 
filled with pure air. This bath is used in cutaneous, l'heumatic, 
syphilitic and similar disoi-ders. 
649. Fomentations consist in the general or local appli- 
cation of woolen cloths wrung out of hot water. They should 
not be so light as to be ineffectual, nor so heavy as to be 
burdensome. They should not be wet enough to drip, nor 
applied so as to expose the body to the surrounding air. A 
fresh cloth should be ready for application before the old one is 
removed, and the change quickly effected. Fomentations are 
effectual in relieving congestion and inflammation. 
650. The Wet Sheet Pack. As this remedial ap- 
pliance will be frequently recommended in the pages of this 
volume, its mode of application is here described. Take a pail 
half filled with cold water, gather together one end of a com- 
mon cotton sheet, and immerse it, allowing it to remain while 
preparing the bed, which may be done as follows: remove all 
the bed-clothes except a coverlet and the pillows, then spread 
upon it, in the following order, two ordinary comfortei’s, one 
woolen blanket, one woolen sheet, (or two woolen sheets if a 
woolen blanket is not at hand); then wring out one-half or two- 
thirds of the water from the wet sheet, spread it smoothly upon 
the blanket, and, the patient being undressed, places himself 
on the sheet, with his arms extended, while an assistant wraps him 
closely and tightly with it, as quickly as possible. Each arm 
may be thus covered by the wet sheet, or may lie outside of it, 
and be covered by wet towels, prepared in the same manner as 
the sheet. Then quickly and tightly cover with the blankets 
and comfoxters, tucking snugly from head to foot. The head 
should also be covered with a wet towel, and a bottle of warm 
water placed to the feet or near enough to keep them warm. 
After the first shock of the chill is ovei', the pack is very 
pleasant and refreshing, and the patient should go to sleep, if 374 
COMMON SENSE MEDICAL ADVISER. 
possible. The ordinary time for a patient to remain in a pack 
is about sixty minutes Thirty or forty minutes is sufficient, if 
he be in a feeble condition. Never wring the sheet out of warm 
water, for one of its principal benefits comes from the vigorous 
reaction induced by its cold temperature. After remaining in 
the pack from thirty to sixty minutes, allow the patient to 
stand on his feet, if he is able, and have the whole surface of 
his body bathed. Rub briskly and dry with towels, or by 
throwing over the body a dry sheet and then rubbing him. The 
dry sheet retains the bodily warmth and is more comfortable, 
but interferes with the completeness and vigor of the rubbing of 
the body. Be sure and establish full reaction, which may be 
known by the warmth of the surface. Oftentimes, when the 
patient is released from the pack, and is being bathed, rolls of 
scales, scurf and skin-clebris, come off, thus giving palpable evi- 
dence of the utility of the pack in freeing the myriads of pores 
of the skin from morbid matter. It is efficient in shortening the 
career of fever, breaking up the onset of colds and is a very 
efficient remedial agent in most chronic diseases, assisting in 
removing causes that continually depress the bodily functions. CHAPTER IV. 
HYGIENIC TREATMENT OF 
THE SICK. 
651. There are two essentials requisite to the successful treat- 
ment of the sick: (1.) Medical skill; (2.) Good nursing. The 
former is necessary in order that the condition of the patient be 
fully understood, and the proper means be employed to effect 
his recovery. The latter is essential, in order that all influences 
favoring the production and development of disease may be 
removed, the tendencies to restoration be promoted by every 
possible means, and the directions of the physician be prop- 
erly observed. 
652. Success in the treatment of the sick requires good nurs- 
ing. Without it, the most skillful physicians fail in effecting a 
cure; with it, the most unqualified may succeed. If certain 
hygienic agencies are essential to the maintenance of health, how 
much more necessary that they be employed in sickness ! If 
certain conditions cause disease, how great the necessity that 
such conditions be obviated and hygienic ones substituted ! 
Notwithstanding the importance of good nursing (which all 
must concede), in the rural districts it is frequently difficult to 
find a professional nurse, or, if one can be obtained, it is often 
impossible for the invalid to procure her services, on account of 
the expense which must necessarily be incurred. Hence, this 
office usually devolves upon some relative who is considered to 
be the best qualified for the position; or, as is often the case, 
necessity demands that the patient be left to a change of nurses. 
653. Woman is generally selected for this important position, 
since she is best adapted to fulfill its duties. Her soft hand and 
soothing voice, her kindly, sympathetic, and provident nature, 376 
COMMON SENSE MEDICAL ADVISER. 
together with her scrupulous cleanliness, render her man’s equal, 
if not his superior, in the capacity of nurse. There are circum- 
stances, however, in which his services are indispensable; hence 
the necessity of being qualified to care for the sick. It may not 
be out of place to specify some of the qualities requisite to con- 
stitute a good nurse, so that all upon whom the care of the sick 
devolves, may acquire them. 
654. A nurse should be attentive to the requirements of 
physician and patient, for she sustains an intimate relation to 
both. She should observe the directions of the physician, and 
faithfully perform them. She should note all the symptoms of 
the patient, and do everything in her power to promote comfort 
and recovery. She should anticipate his wishes, and not cause 
him to ask for everything which he desires. In so far as prac- 
ticable, let his wishes be gratified. The senses of the sick often 
become morbidly acute, and those things which in health would 
pass unnoticed, in sickness are so magnified as to occasion annoy- 
ance and vexation. Sick persons are not all alike, and the 
peculiarities of each must be studied separately. The nurse 
must be hind, but firm, and not yield to such whims of the 
patient as will be detrimental to his recovery; neither must she 
arouse his dislike or anger by opposition, but endeavor to win 
him from his delusions. The feelings of the patient should never 
be trifled with, for idealities become realities to him. Secure 
his good-will, confidence and respect, show him that an interest 
is taken in his welfare, sympathize with him, listen to his vagaries, 
but do not encourage them. 
655. The nurse should possess an inexhaustible store of pa- 
tience. Disease affects the mind of the patient and pervades it 
with strange delusions. He is often querulous, fretful and 
unreasonable, and should be treated with kindness, forbearance 
and sympathy. The nurse should always be cheerful, look on 
the bright side of every circumstance, animate him with encour- 
agement and inspire him with hope. Hope is one of the best of 
tonics. It stimulates the flagging, vital energies, and imparts 
new life to the weak and exhausted forces. Gloom, sadness and 
despondency depress the vital forces and lead to death. In 
156r we have observed that the body is materially influenced 
and affected by the mind. We have seen patients rapidly SICK ROOM. 
377 
sinking, who had given up to die, and were quietly awaiting the 
coming of the death-angel, snatched as it were from his grasp, 
and restored to health, by words of cheer and encouragement. 
The nurse should possess moral principles, which alone can 
win the confidence of the patient. She should have judgment, 
circumspection, intelligence, forethought, alacrity, carefulness 
and neatness. In a word, she should exercise common sense. 
656. We deem it but justice to say a word in behalf of the 
nurse. She too is a human being, subject to disease, and unless 
hygienic conditions are observed, will soon be stricken low by 
its presence. She must be relieved occasionally and get rest, or 
she cannot long withstand the combined influence of fatigue 
and disease. Her office is an arduous one at best, and the long, 
weary hours of night-watching should be compensated by exer- 
cise in the open air, as well as sleep during the day. Unless this 
is done, nature will become exhausted, and sleep will intrude itself 
upon her at the time when the greatest diligence is required for 
the welfare of the patient—when his vital powers are at their 
lowest ebb, in “ the wee sma’ hours o’ morning.” She should be 
supplied with plenty of suitable food during the night, to sustain 
her powers and to serve as a safeguard from the invasion of 
disease. She should be treated with kindness and respect, else 
her disposition may become morose and reflect itself upon the 
patient, rendering him peevish and despondent. 
657. Til© Sick Room should be as comfortable, cheerful, 
and pleasant, as circumstances will allow. Let the room he 
large and airy, with high w'alls, and furnished with a stove—or 
better—a lire-place. All articles of clothing and furniture, not 
necessary to the comfort of the patient, should be removed from 
the room, and in malignant or contagious diseases the carpets, 
even, should not be permitted to remain. The surroundings beget 
happiness or gloom, in proportion as they are pleasant or 
disagreeable. A tidy attendant, a few flowers and books, 
wonderfully enhance the cheerfulness of the room. Permit no 
unnecessary accumulation of bottles, or any thing that can in 
any way render the room unpleasant. Medicines, drink or nour- 
ishment, should never be left uncovered in the sick-room, since 
they quickly absorb the gaseous emanations from the patient, and 
become unfit for the purpose which they were intended to 378 
COMMON SENSE MEDICAL ADVISEE. 
subserve. Their presence gives the room an untidy appearance, 
suggestive of filth and slovenliness, and imparts to the patient a 
feeling of loathing and disgust for articles of diet. 
658. The Bed should not be of feathers, on account of 
their undue warmth, which causes a sensation of languor through- 
out the system. A husk or sea-grass mattress, or even a straw bed, 
covered with a cotton quilt, is far preferable. The bedding 
should be changed at least once every day. It is better that the 
bed should be away from the wall, so as to admit of greater 
freedom of movement about it. 
659. Pure Air is necessary to the continuance of life. The 
air in the sick-room should be kept as pure as that without. 
That which is so necessary in health, is indispensable in sickness. 
The importance, therefore, of a perfect and free ventilation of 
the sick-room cannot be too thoroughly impressed: and yet to 
properly secure this end, may call forth a considerable amount 
of ingenuity on the part of the nurse. A window should be 
open, but the current of air must not be allowed to blow directly 
upon the patient. One window may be raised from the bottom 
and another lowered from the top. This will permit the entrance 
of pure air from without, and the exit of the vitiated from 
within. The patient, if sufficiently covered in bed, is not liable 
to take cold from a proper ventilation of his room. Especially is 
this true, when the bodily temperature is raised by febrile or 
inflammatory infections. The temperature of a room is no indi- 
cation of tho, purity of the air. It is a prevalent—though mistaken 
notion—that because a room is cold, the air must be pure. Cold 
is as readily contaminated with impurities as heat; so it is not 
sufficient that the room be kept cool, but the air should be fre- 
quently changed. During convalescence, great care is necessary 
to protect the patient from taking cold. Air that is admitted 
into the sick-room should not be contaminated by passing over 
foul drains, privies, or other sources of infection, since, instead oi 
invigorating, it depresses the physical forces and generates 
disease. Were our visual senses cognizant of atmospheric impu- 
rities, no argument would be necessary in favor of free ventilation 
to obtain pure air. 
660. Light is as necessary to health as is pure air. Both 
ere God-given invigorators. Banish either for any continuous WARMTH. 
379 
length of time, and serious results follow. The strong, robust 
man, when deprived of light, soon degenerates into a feeble, 
sickly being, and finally dies. 
According to the investigations of the Massachusetts Medical 
Society, it is found that absence of sunlight, together with 
moisture, not only favor the development of tubercular con- 
sumption, but act as an exciting cause. It is well known that 
persons living in shaded dwellings often suffer from forms of 
disease which resist all treatment until proper admission of 
light is secured. 
The Physician to the Emperor of Russia found upon examin- 
ation that patients confined in well lighted wards, were four 
times as liable to recover as were those in poorly lighted rooms. 
Children reared away from the sunlight are apt to be de- 
formed and idiotic, while those partially deformed have been 
restored by being admitted to the light. 
661. Patients sometimes wish to have their rooms darkened, 
because the light is painful to their weak and sensitive eyes. It 
is far better to shade the eyes and admit the sunlight into the 
room, since its rays cause chemical changes to take place, and 
thus favor the return of health. Many invalids can credit their 
recovery to the influence of a sun bath. There are, however, 
conditions in which the patient should be screened from the 
light. In such cases a little arrangement of the curtains or 
shutters will accomplish all that is to be desired. 
Patients convalescing from acute, or suffering from chronic 
diseases, should receive the influence of light in the open air, 
and be in it several hours each day. Light and pure air stimu- 
late a healthful development, induce cheerfulness, hope and 
recovery, while darkness begets gloom, sadness, despondency, 
disease and ultimately, death. 
662. Warmth is essential to the well being of the patient 
and it is necessary that a proper temperature be maintained in 
the room. Except in very warm weather a little fire should be 
kept in a stove—or what is preferable—in a fire-place or open 
grate, and at the same time fresh air should be admitted from 
without, and thus a uniform temperature will be preserved. This 
arrangement is especially necessary in localities where great va- 
riations in temperature are experienced during the day and night. 380 
COMMON SENSE MEDICAL ADVISER. 
The normal temperature of the body ranges from 98° to 99° 
F. The minimum occurs from 2 to 6 a. m. The maximum, from 
1 to 6 p. m. The deviation of a few degrees from this standard, 
indicates disease, and the greater the deviation, the greater its 
severity. During the early stages of acute diseases, the animal 
heat is generally increased, and should be allayed by bathing, 
and cooling or acidulated drinks. In the latter stages, the tem- 
perature becomes diminished and the condition of the system is 
favorable to congestions, which are most likely to occur between 
the hours of 2 and 6 a. m., when the vital powers are lowest. The 
patient then becomes feeble, his extremities cold, and he has what 
is termed a “ sinking spell,” and perhaps dies. It is during 
these hours that additional covering, hot bricks to the feet, 
or jugs of hot water at the thighs and armpits, friction upon the 
surface, stimulating drinks, and increased vigilance on the part 
of the nurse will often save the patient’s life. But, unfortunately, 
at these hours the nurse is apt to get sleepy and inattentive, the 
demands of the patient go unheeded, and his life pays the 
forfeit. 
Persons suffering from chronic diseases, or those in feeble 
health, should conserve their vital energies by dressing warmly, 
wearing flannels next the skin, and carefully protecting the feet 
from cold and moisture. 
663. Cleanliness cannot be too thoroughly impressed 
upon the minds of those who have the care of the sick. Filth 
iness is productive of disease and favorable to its development. 
Bathing at least once a day, with pure, soft water and toilet- 
soap, is strongly urged, and as this is designed for cleanliness, 
the temperature of the bath should be made agreeable to the 
patient. For the remedial effects of baths, see article on “Water 
as a Remedial Agent,”—Chap. Ill, Part III. Bathing opens mil- 
lions of avenues of the skin, allowing the effete animal matter 
to escape as soon as it comes to the surface, thus relieving the in- 
ternal organs—now struggling for recovery—from the necessity 
of ejecting it. 
664. The Clothing and Bedding of the Pa- 
tient in acute diseases, should be changed every day and 
thoroughly aired, if not washed. As soon as removed they 
should be taken from the room, replaced by others well aired and THE DIET. 
381 
warmed. The hands and face of the patient should be bathed 
frequently, hair combed, teeth brushed, nails cleaned, lips 
moistened, and everything about him kept clean and tidy. These 
observances, although in themselves trifling, promote comfort 
and cheerfulness, and contribute largely to the recovery of the 
sick. All excretions from the patient should be buried; not com- 
mitted to privies to communicate disease to those who frequent 
them. 
665. The Diet sustains a very important relation to 
health. During the progress of acute disease, the appetite is 
generally much impaired, if not entirely absent. It should then 
be the study of the nurse to devise such articles of nourishment 
as will be acceptable to the patient and suitable to his condition. 
Variety is necessary. He soon tires of one kind of diet. His 
food should be light, nutritious and easy of digestion. 
Each individual disease requires a diet adapted to its peculiari- 
ties. Those of an inflammatory character require a non-stimulating 
diet, as gruel, barley-water, toast, etc. An exhausted or enfeebled 
condition of the brain, unattended by irritability, demands a 
stimulating diet, as beef, eggs, fish, Graham bread, oysters, etc. 
In wasting diseases, where the temperature of the system is low, 
beef, fatty substances, rich milk, sweet cream, and other carbo- 
naceous articles of diet, are recommended. In the various forms 
of chronic ailments, the diet must be varied according to the 
nature of the disease and the peculiarities of the patient. De- 
ranged digestion is generally an accompaniment of chronic 
diseases. A return to normal digestion should be encouraged by 
selecting appropriate articles of food, and paying due regard to its 
quantity and quality, as well as to the manner and time of eating. 
The appearance of food, and the manner in which it is offered, 
have much to do with its acceptance or rejection by the patient. 
Let the nourishment have a neat and inviting appearance, and be 
presented in a nice clean dish, of a size and shape appropriate to 
the quantity. More food than will be eaten by the patient should 
not be placed before him at one time, since a great quantity 
excites disgust and loathing. In taking nourishment, drink, or 
medicine, the patient, if feeble, should not be obliged to change 
his position, nor should he be compelled to receive them upon 
his face, neck, and clothing, instead of into his mouth. 382 
COMMON SENSE MEDICAL ADVISER. 
666. Beef* Tea furnishes an excellent nourishment for the 
sick, but there are few, even among pi-ofessional nurses, who know 
how to properly prepare it. I give one or two good recipes. 
One method is to chip up the lean of beef, fine, put it in a porce- 
lain or tin saucepan, cover it with cold water, and bring it up to 
just below the boiling point, at which temperature retain it for 
ten minutes, then season and serve. Another method is similar 
to the foregoing, with this difference, that the juices of the meat 
are squeezed through a piece of muslin or crash, making the tea 
richer. Another way, which I consider preferable to either of 
the above, is to take lean beef, cut it into fine bits, put them in a 
tightly covered vessel, which is placed in a kettle of water kept 
boiling. Thus the whole strength of the juice will be obtained 
from the meat without losing any of its properties. It can be 
seasoned to the taste, and reduced with water to suit the needs 
of the patient. 
667. Sleep is “Nature’s grand restoi-er, a balm to all man- 
kind; the best comforter of that sad heart whom fortune’s spite 
assails.” It is necessary in health, and doubly so in sickness. 
During sleep, the vital energies recuperate, the forces are less 
rapidly expended, and the strength increases. It is the great 
source of rest and refreshment. Often a day’s rest in bed, free 
from the cares and anxieties of an active life, is sufficient to ward 
off the approach of disease. If quiet and rest are essential to 
recuperation in health, their necessity in disease must be appar- 
ent. Life and death frequently depend on tranquility and repose, 
and the least noise or confusion disturbs the sufferer and dimin- 
ishes the chances for his recovery. Nothing annoys sick or nervous 
persons more than whispering and the rustling of newspapers. 
If conversation be necessary, let the tones be modified, but never 
whispei’. In sickness, when the vital foi-ces are low, the more 
natural rest and sleep the patient has, the greater his prospect 
for recovery. As a rule, a patient should never be awakened 
when sleeping quietlyy not even to take medicine, unless in 
extreme cases. If the patient does not sleep, the cause should 
be ascertained and the appropriate remedies employed: if it arises 
from rush of blood to the head, cooling lotions should be applied, 
and warmth at the feet; if from restlessness or general irritability, 
a sponge bath, followed by friction; if the wakefulness is due to VISITING THE SICK. 
noise or confusion, quiet is the remedy. When these means 
fail, anodynes, or nervines, should be employed. Eying on 
the side instead of the back should be practiced. Patients 
afflicted with chronic diseases, on rising, should take a cold 
bath, dry the surface quickly with a coarse towel, followed 
by friction with the hand. Great benefit may be derived by 
following these suggestions, when the nature of the disease is 
not such as to forbid it. 
668. Exercise and rest necessarily alternate with each 
other. Exercise, so necessary to health, in many forms of dis- 
ease greatly contributes to recovery. It sends the sluggish 
blood coursing through the veins and arteries with increased 
force and rapidity, so that it reaches every part of the system, 
supplying it with nourishment. It increases the waste of old 
material and creates a demand for new. 
Convalescing patients, or those suffering from chronic diseases, 
whenever the weather will permit, should take exercise every 
day in the open air. This should be done with regularity. The 
amount of exercise must be regulated by the strength of the 
patient; never take so much as to produce fatigue, but as the 
strength increases the exercise may be increased proportionately. 
Some interesting employment commensurate with the patient’s 
strength should be instituted, so that the mind may be agreeably 
occupied with the body. 
When unable to take active exercise, the invalid, properly pro- 
tected by sufficient clothing, should ride in a carriage or boat, 
and each day a new route should be chosen, so that a change of 
scenery may be observed, thus arousing new trains of thought, 
which will be exhilarating and prove beneficial to him. 
669. Sexual Influences. During the progress of dis- 
ease or convalescence, entire continence is enjoined. It is then 
necessary that all of the vital energies be employed in effecting 
a recovery from disease, without having the additional tax 
imposed of overcoming the debilitating effects of sexual expen- 
diture. This holds true with regard to all diseases—especially 
those of the nervous system and genito-urinary organs. 
670. Visiting- the Sick may be productive of good or 
evil results. The influence of the mind upon the bodily func- 
tions has already been alluded to, 156). Mental impressions 384 
COMMON SENSE MEDICAL ADVISER. 
made upon the sick exert a powerful influence upon the termina- 
tion of disease. The chances of recovery are in proportion to 
the elevation or depression of spirits. Pleasant, cheerful asso- 
ciations animate the patient, inspire hope, arouse the vital 
energies and aid in his recovery. While disagreeable and 
melancholy associations beget sadness and despondency, dis- 
courage the patient, depress the vital powers, enfeeble the body 
and retard recovery. 
Unless persons, who visit the sick, can carry with them joy, 
hope, mirth and animation, they had better stay away. This 
applies equally in acute and chronic diseases. It does not matter 
what a visitor may think with regard to the patient’s recovery, 
an unfavorable opinion should never find expression in the sick- 
room. Life hangs upon a brittle thread, and often that frail 
support is hope. Cheer the sick by words of encouragement, 
and the hold on life will be strengthened; discourage, by uttering 
such expressions as, “ How bad you look ! ” “ Why, how you 
have failed since I saw you last! ” “I would have another 
doctory one who knows something! ” “You can’t live long if you 
don’t get help ! ” etc., and the tie which binds them to earth is 
snapped asunder. The visitor becomes a murderer ! Let all per- 
sons be guided by this rule: Never go into the sick-room without 
carrying with you a few rays of sunshine! 
If the patient is very weak the visitor may injure him by 
staying too long. The length of the visit should be graduated 
to the strength of the invalid. Never let the sufferer be wea- 
ried by your too frequent coming or too long remaining, nor by 
having too many visitors at once. Above all things, do not 
confine your visitations of the sick to the Sabbath. Many do 
this and give themselves credit for an extra "amount of piety on 
account of it, when if they would scrutinize their motives more 
carefully, they would see that it was but a contemptible resort 
to save time. The sick are often grossly neglected during the 
week only to be visited to death upon the Sabbath. 
671. The Use of Tobacco and Opium. The 
recovery of the sick is often delayed—sometimes entirely pre- 
vented—by the habitual use of tobacco or opium. In acute 
diseases, the appetite for tobacco is usually destroyed by the 
force of the disease, and its use is, of necessity, discontinued: USE OF TOBACCO AND OPIUM. 
385 
but in cln-onic ailments, the appetite remains unchanged, and the 
patient continues his indulgence greatly to the aggravation of 
the malady. 
The use of tobacco is a pernicious habit in whatever form it is 
introduced into the system. Its active principle—Nicotine—which 
is an energetic poison, exerts its specific effect on the nervous 
system, tending to stimulate it to an unnatural degree of activity, 
the final result of which is weakness, or even paralysis. The 
horse, under the action of whip and spur, may exhibit great spirit 
and rapid movements, but urge him beyond his strength with 
these agents, and you inflict a lasting injury. Withhold the 
stimuli, and the drooping head and moping pace indicate the sad 
reaction that has taken place. This illustrates the evils of habitu- 
ally exciting the nerves by the use of tobacco, opium, narcotic or 
other drugs. Under their action, the tone of the system is 
greatly impaired and it responds more feebly to the influence of 
curative agents. Tobacco itself, when its use becomes habitual 
and excessive, gives rise to the most unpleasant and dangerous 
pathological conditions. Oppressive torpor, weakness or loss of 
intellect, softening of the brain, paralysis, nervous debility, dys- 
pepsia, functional derangement of the heart, diseases of the liver 
and kidneys, are not uncommon consequences of the excessive 
employment of this plant. A sense of faintness, nausea, giddi- 
ness, dryness of the throat, trembling, feelings of fear, disquie- 
tude, apprehensiveness, and general nervous prostration must 
frequently warn persons addicted to this habit, that they are 
sapping the very foundation of health. Under the continued 
operation of a poison, inducing such symptoms as these, what 
chance is thei’e for remedies to accomplish their specific action? 
With the system already thoroughly charged with an influence 
antagonistic to their own, and which is sux’e to neutralize their 
effect, what good can medicine do ? 
Says Dr. King, “ A patient under treatment should give up the 
use of tobacco, or his physician should assume no responsibility 
in his case, further than to do the best he can for him.” In my 
own extensive experience in the treatment of chronic diseases, I 
often have found it necessary to resort to the same restriction. 
The “ opium habit,” to which allusion has also been made, is 
open to the same objections, and must be abandoned by all who 386 
COMMON SENSE MEDICAL ADVISER. 
would seek recovery. Let those who are addicted to this per- 
nicious practice, listen to the voice of Wisdom, exclaiming iu 
tones of gentle pity and tender remonstrance, “ Why shouldest 
thou destroy thyself ? ” and at once reform. PAET IV. 
DISEASES AND THEIR REME- 
DIAL TREATMENT. 
INTRODUCTION. 
672. “Knowledge is Power.” That knowledge which 
is conducive to self-preservation is of primary importance. 
That great educator, profound thinker, and vigorous writer, 
Herbert Spencer, has pertinently said that, “ As vigorous health 
and its accompanying high spirits, are larger elements of happi- 
ness than any other things whatever, the teaching how to 
maintain them is a teaching that yields to no other whatever. 
And therefore we assert that such a course of physiology as is 
needful for the comprehension of its general truths and their 
bearings on daily conduct is an all-essential part of a rational 
education.” 
673. Believing that the diffusion of knowledge for the preven- 
tion of disease is quite as noble a work, as the alleviation of phys- 
ical suffering by medical skill, I have devoted a large portion of 
this volume to the subjects of physiology and hygiene. These I 
endeavored to present in as familiar a style as possible, that 
they may be understood by every reader. Freely as I have 
received light upon these subjects have I endeavored to reflect 
it again, in hopes that a popular presentation of these matters, 
made plain and easy of comprehension to all people, may lead 
the masses into greater enjoyment of life—the result of a better 
preservation of health. This I do in part as a public acknowl- 
edgement of my obligation to society, to whom every professional COMMON SENSE MEDICAL ADVISER. 
man is a debtor. He belongs to it, is a part of its common 
stock, and should give as well as receive advantages—return as 
well as accept benefits. I know of no better way to signify my 
appreciation of the public confidence and patronage so gener- 
ously accorded me, than to offer this volume to the people at a 
price less than the actual cost for an ordinary sized edition. 
This I do as a token of the cordial reciprocation of their good 
will. In giving to the people wholesome advice, by which they 
may be enabled to ward off disease and thus establish the health 
of multitudes, I believe I shall receive the hearty approval of 
the people, as well as the approbation of my own conscience, 
both of which are certainly munificent rewards. I believe that 
good deeds are always rewarded, and the physician who pre- 
vents sickness shows a genuine and earnest loyalty to the com- 
mon interests of humanity. 
674. I have no respect for the motives of those medical men 
who would withhold such information from the people as will 
direct the masses how to take care of themselves, and thereby 
prevent much sickness and suffering. Nor is the diffusion of such 
knowledge derogatory to the best interests of the true and com- 
petent physician. The necessity for his invaluable services can 
no more be set aside by popularizing physiological, hygienic and 
medical truths, than we can dispense with those of the minister 
and lawyer by the inculcation of the principles of morality in our 
public schools. The common schools do not lessen the necessity 
for higher seminaries or universities, but rather contribute to 
their prosperity. Nor am I so presumptuous as to anticipate that 
I could possibly make this volume so instructive as to render 
“ every man his own physician.” No man can with advantage 
be his own lawyer, carpenter, tailor and printer. Much less 
can he hope to artfully repair his own constitution when shat- 
tered by grave maladies, that not only impair the physical 
functions, but weaken and derange the mental faculties. What 
physician presumes to prescribe for himself, when suddenly 
prostrated by serious illness? He very sensibly submits to 
the treatment of another, because he realizes that sickness im- 
pairs his judgment, and morbid sensations mislead and unfit 
him for the exercise of his skill. If this be true of the physician, 
with what greater force does it apply to the non-professional ? INTRODUCTION. 
389 
If a sick sea-captain be unfit to stand at the helm and direct his 
ship, how utterly incompetent must be the raw sailor when sim- 
ilarly disqualified. Nor is the physician as competent to treat 
those near and dear to him, when they are suffering from danger- 
ous illness, as another medical man not similarly situated, whose 
judgment is not liable to be misled by intense anxiety and affec- 
tionate sympathy. 
675. Notwithstanding all these facts however, a knowledge 
on the part of the non-professional, of something more than 
physiology and hygiene, and appertaining more closely to med- 
icine proper, will many times prove invaluable. 
(1.) In the inceptive stage of many acute affections which, if 
unheeded, gradually assume a threatening aspect, endangering life 
and demanding the services of the most skilled physician to 
avert fatal results, the early administration of some common 
domestic remedy, as a cathartic, or a sweating tea, associated 
with a warm bath, a spirit vapor-bath, or a hot foot-bath, will 
very often obviate the necessity for calling a family physician, 
and many times save days and weeks of sickness and suffering. 
(2.) So, likewise, are there numerous acute diseases of a milder 
character that are easily and unmistakably recognized without 
the possession of great medical knowledge, and which will readily 
yield to such plain, simple medical treatment as is within the 
ready reach of all who strive to acquaint themselves with 
the rudiments of medical science. But in sudden and painful 
attacks of acute disease, life may be suddenly and unexpectedly 
jeopardized, and immediate relief prove necessary. While under 
these circumstances the prompt application of such domestic 
treatment as good common sense, guided by a knowledge of 
those first principles of medical learning which I shall hereafter 
endeavor to make plain, may result in speedy and happy relief, 
yet at the same time there should be no delay in summoning a 
competent physician to the sufferer’s assistance. 
(3.) Then, and not least important, there are the various chronic 
or lingering diseases, from all of which few individuals indeed, 
who pass the meridian of life, entirely escape. In this class 
of ailments there is generally no immediate danger, and 
therefore time may be taken by the invalid for studying his dis- 
ease and employing such remedies as are best suited for its 390 
COMMON SENSE MEDICAL ADVISER. 
removal. Or, if of a dangerous or complicated character, and 
therefore not so readily understood, he may consult, either per- 
sonally or by letter, some learned and well known physician, who 
makes a specialty of the treatment of such cases, and whose 
large experience enables him to excel therein. 
676. In consideration, therefore, of the foregoing facts, I 
deem it most profitable for my readers that Part Fourth of this 
volume should be devoted as follows: 
(1.) The milder forms of uncomplicated acute diseases, which 
may be readily and unmistakably recognized, and successfully 
managed without professional aid, will receive that attention 
necessary to give the reader a correct idea of them, and their 
proper remedial treatment. 
(2.) I shall devote only such attention to the severe and 
hazardous forms of acute diseases as is necessary in order to con- 
sider their initial stage, with their proper treatment, not attempt- 
ing to trace their numerous complications, nor portray the many 
pathological conditions that are liable to be developed. For, 
by devoting much space to the latter, I could not presume to 
qualify my non-professional readers for successfully treating such 
obscure and dangerous conditions. 
(3.) I shall devote the largest amount of space to a careful 
and thorough consideration of those chronic diseases, which, by 
a little study, may be readily recognized and understood by the 
masses, and for the cure of which, I shall suggest such hygienic 
treatment and domestic remedies as may be safely employed by 
all who are in quest of relief. In the more dangerous, 
or complicated forms of chronic diseases, the correct diagnosis 
and successful treatment of which tax all the skill possessed by 
the experienced specialist, the invalid will not be misled into the 
dangerous policy of relying upon his own judgment and treat- 
ment, but will be counseled not to postpone, until too late, the 
employment of a skillful physician. 
677. In advocating Specialists, I do not desire to be understood 
as favoring those itinerant self-styled doctors, or “professors,” 
who perambulate the country, imposing upon all who may be so 
unfortunate as to fall into their hands. No matter what preten- 
sions they may make, nor how familiar they may be with unin- 
telligible terms, they are always unreliable, and ninety-nine out MEDICAL DIAGNOSIS. 
391 
of every hundred of them are swindlers, who know nothing about 
medicine, and when their victims seek them, are never to be 
found: they have accomplished their object, got the patient’s 
money, and gone. Their positive assurances amount to nothing. 
It is axiomatic, that a physician who understands his profession, 
will get business enough at home, without having to tramp about 
the country to “ drum up ” custom. 
678. The apportionment of space which is made in consider- 
ing the various diseases and their different stages, as well as the 
course which the people are advised to pursue under the different 
circumstances of affliction, is not in accordance with the plans 
and recommendations that have been made by others who have 
written works on domestic medicine. Most of these authors have 
attempted, by lengthy considerations, to teach their readers how 
to treat themselves without the services of a physician, even in 
the most hazardous forms of disease. In such dangerous maladies 
as typhoid, typhus, yellow and scarlet fevers, typhoid pneumonia, 
and many others, in which life is imminently imperiled, such in- 
struction and advice is decidedly reprehensible, as it may lead 
to the most serious consequences. I am confident, therefore, 
that the manner of disposing of the different subjects which 
are discussed in the succeeding chapters, and the course of 
action that is advised, will commend themselves to my readers as 
being such as are calculated to promote and subserve their best 
interests. 
MEDICAL DIAGNOSIS. 
679. Skill in the art of healing is indicated in three ways: 
(1.) By ascertaining the symptoms, seat and nature of the dis- 
ease, which is diagnosis; (2.) By foretelling the probable ter- 
mination, which is prognosis; (3.) By the employment of right 
and appropriate remedies, which is treatment. Of these three 
requisites to a prosperous issue, nothing so distinguishes the ex- 
pert and accomplished physician from the mere pretender as his 
ready ability to interpret correctly the location, extent and 
character of an affection by its symptoms. By medical diagnosis 
then is understood the discrimination between diseases by certain 
symptoms which are distinguishing signs. Every malady is ac- 
companied by its characteristic indications, some of which are 392 
COMMON SENSE MEDICAL ADVISER. 
diagnostic, i. e., they particularize the affection and distinguish 
it from all others. 
680. Medical diagnosis is both a science and an art; a science 
when the causes and symptoms of a disease are understood, and 
an art when this knowledge can be applied to determine its 
location and exact nature. Science presents the general prin- 
ciples of practice; art detects among the characteristic symptoms 
the differential signs, and applies the remedy. Da Costa aptly 
remarks : “No one aspiring to become a skillful observer can 
trust exclusively to the light reflected from the writings of 
others ; he must carry the torch in his own hands, and himself 
look into every recess.” 
681. The critical investigation of symptoms, with the view of 
ascertaining their signs, is essential to successful practice. With- 
out closely observing them, we cannot accurately trace out the 
diagnosis, and a failure in detecting the right disease is apt to 
be followed by the use of wrong medicines. 
682. General diagnosis considers the surroundings of the 
patient as well as the actual manifestations of his disease. It 
takes into account the diathesis, i. e., the predisposition to cer- 
tain diseases in consequence of peculiarities of constitution. We 
recognize constitutional tendencies, which may be indicated by 
the contour of the body, its growth, stature and temperament, 
since all these facts greatly modify the treatment. Likewise the 
sex, age, climate, habits, occupation, previous diseases as well as 
the present condition, must be taken into account. 
683. Auscultation, as practiced in detecting disease, consists 
in listening to the sounds -which can be heard in the chest. 
684. Percussion consists in striking upon a part with the view 
of appreciating the sound which results. The part may he struck 
directly with the fingers held in a bundle, but more generally one 
or more fingers of the other hand are interposed between the 
points of the fingers and the part to be percussed, that they, 
instead of the naked chest, may receive the blow; or, instead 
of the fingers, a flat piece of bone or ivory, called a Pleximeter, is 
placed upon the chest to receive the blow. 
685. Latterly, improved instruments greatly assist the practi- 
tioner of medicine in perfecting this art. The Microscope assists 
the eye and helps to reveal the appearance and character of the MEDICAL DIAGNOSIS. 
393 
excretions, detecting morbid degenerations; Chemistry discloses 
the elementary constitution of the urine, which also indicates the 
morbid alterations occurring in the system; with the Pleximeter, 
we can determine the condition of an internal organ, by the sound 
given when the external surface is percussed; the ear, with the 
aid of the Stethoscope, detects the strange murmurs of respira- 
tion, the fainter, more unnatural pulsations of life, and the 
obscurer workings of disease; 
with the Spirometer we deter- 
mine the breathing capacity of 
the lungs, and thus ascertain 
the extent of the inroads made 
by disease (I use Dr. Brown’s 
Spirometer, which, for every 
inch of tubercular deposit in 
the lungs, indicates it by a 
falling off of forty cubic inches 
on the scale attached to the 
instrument); the Dynamometer 
records the lifting ability of 
the patient; the Thermometer 
tells the morbid variation in 
the bodily temperature ; various instruments inform us of the 
structural changes causing alterations in the specific gravity of 
fluids, e. g., theUrinometer indicates those occurring in the urine, 
and thus, as the facilities for correct diagnosis increase, the art 
of distinguishing and classifying diseases becomes more perfect, 
and their treatment more certain. 
Fig. IJj.5. 
Dr. Brown’s Spirometer. 
686. While physiology instructs us in relation to the per- 
formance of all the natural functions, pathology shows the 
lesions, and altered conditions, as well as the extent of morbid 
departure, and Cerebral Physiology is shedding its refulgent 
light upon the relationship between mental and physical func- 
tions, the forces of mind are resolved, even the phenomena of 
thought itself, to furnish the diagnostic signs of disease. The 
temperaments are investigated in an original manner, to evolve 
more completely the peculiarities of constitution of each indi- 
vidual, and to more perfectly analyze disease, in order that 
improvement in the practice of medicine maybe attained. Thus, 394 
COMMON SENSE MEDICAL ADVISER. 
not only diagnosis, but all departments of the healing art are 
improving year by year. 
687. By symptoms we mean the evidence of any morbid 
effect or change occurring in the human body, and it requires 
close observation and well-instructed experience to convert these 
symptoms into diagnostic signs. Suppose “ Old Probabilities ” 
(as we commonly personate the invaluable Signal Department) 
hangs out his warning tokens all along our lake borders and 
ocean coasts; our sailors behold the fluttering symbols, but no 
one understands their meaning. The storm rages and fearful 
disaster follows. But if these signals are understood, a safe 
harbor is sought and the mariner is protected. So disease may 
hang out all her signals of distress, in order that they may be 
seen, but unless translated correctly, and a remedial harbor 
sought, these symptoms are of little practical moment. 
688. Undoubtedly the reason why so many symptom-doctors 
blunder is because they prescribe according to the apparent 
symptoms, without any real reference to the nature of the 
affection. They fail in discovering how far a symptom points 
out the seat, and also the progress of a disease. They do not 
make a proper deduction of signs from the symptoms. The 
practical purpose of all science is to artfully apply knowledge 
to salutary and profitable uses. The patient himself may care- 
fully note the indications, but it is the expert physician who can 
tell the import of each symptom. 
689. Symptoms are within every one’s observation, but the 
physician only knows the nature and value of signs. We have 
read an anecdote of Galen, the Father of Herbalists, who was a 
distinguished physician in his day, which illustrates the distinc- 
tion between sign and symptom. Once, when dangerously ill, 
he overheard two of his friends in attendance upon him recount 
his symptoms, such as, “ Redness of the face, a dejected, haggard 
and inflamed appearance,” etc. He cried out to them to adopt 
every necessary measure forthwith, as he was threatened with 
delirium. The two friends saw the symptoms well enough; but 
it was only Galen himself, though the patient, who was able to 
deduce the sign of delirium—that is, he alone was able to 
translate those symptoms into signs. To determine the value of 
symptoms, as signs of disease, requires close observation. MEDICAL DIAGNOSIS. 
395 
INTERPRETATION OE SYMPTOMS. 
690. I will refer to a few symptoms which any non-profes- 
sional reader may readily observe and understand. 
691. Position Of Patient. When a patient is dis- 
posed to lie upon his back continually, during the progress of 
an acute disease, it is a sign of muscular debility. If he mani- 
fests no desire to change position, or cannot do so, and becomes 
tremulous at the least effort, it indicates general prostration. 
When this position is assumed, during the progress of continued 
fever, and is accompanied by involuntary twitching of the 
muscles, picking of the bed-clothes, etc., then look out, for 
danger is imminent, and the patient is sinking. Fever, resulting 
from local inflammation, does not produce muscular prostra- 
tion, and the patient seldom or never assumes the supine 
position. If this inflammation be in the extremities, those parts 
are elevated in order to lessen the pressure of the blood, which 
a dependent position increases. 
692. For illustration let us change the scene, and introduce 
a patient with head and shoulders elevated, who prefers to sit up, 
and places his hands behind him and leans back, or leans forward 
resting his arms and head upon a chair. The next week he is 
worse, and no longer tries to lie in bed, but sits up all the time; 
note the anxious expression of countenance, the difficult or hur- 
ried breathing, the dry and hacking cough, and observe that the 
least exertion increases the difficulty of respiration and causes 
palpitation of the heart. These plain symptoms signify thoracic 
effusion—the collection of water about the lungs. 
693. The Countenance displays diagnostic symptoms 
of disease. In simple, acute fever, the eyes and face are red and 
the respiration is hurried; but in acute, sympathetic fever, these 
signs are wanting. We cannot forget the pale, sharp, contracted 
and pinched features of those patients whose alse (wiiigs of 
the nostrils) contract and expand alternately by the acts of 
respiration. How hard it was for them to breathe, This con- 
traction and expansion of the nostrils indicate active congestion 
of the lungs. 
694. As a general rule, chronic inflammation of the stom- 
ach, duodenum, liver and adjacent organs, imparts a gloomy COMMON SENSE MEDICAL ADVISEE. 
expression to the countenance, at the same time the eye is dull, 
the skin dusky, or yellow, and the motions are slow. But 
in lung diseases, the spirits are buoyant, the skin is fair, and 
the cheeks flushed with fever and distinctly circumscribed with 
white, for delicacy and contrast, almost outrival in beauty 
the hues of health. Note, too, the pearly lustre and sparkling 
light of the eye, the quivering motion of the lips and chin, all 
signs of pulmonary disease. 
695. We were once called in consultation to visit a young 
lady whose sallow pallor, fullness of the eyelids, puffy condition 
of the lips, morbid appetite and constipated condition of the 
bowels, had led the attending physician to diagnose chronic 
inflammation of the liver. When we reminded him that he was 
confounding chlorosis (green sickness) with chronic hepatitis, he 
referred to the constipated condition of the bowels, loaded 
tongue, and yellow skin, as indicating biliary derange- 
ment, and had forgotten that in this latter affection the white 
coat of the eye is also deeply tinged with yellow. We then 
satisfied him that the urine was not yellow nor the stools light 
clay-colored, neither was there any tenderness in the region of 
the liver, when he admitted his error, but by way of pleasantry 
remarked, that according to Eberle, Marshall Hall, and other 
standard writers, the remedies that he had employed were appli- 
cable to either derangement! It is hardly worth while to palliate 
a blunder, and yet we have always been amused with the adroit- 
ness of his ready reply. 
696. The Story of Sexual Abuse is plainly told 
by the downcast countenance, the inability to look one fairly 
in the face, the peculiar lifting of the upper lip and the furtive 
glance of the eyes. The state of the mind and of the nervous 
system corroborate this evidence, for there seems to be a desire 
to escape from conversation and elude society. The mind seems 
engrossed and abstracted, the individual appears in a constant 
brown study, is forgetful and loses nearly all interest in the 
ordinary affairs of life. The whole appearance of a patient, 
suffering from spermatorrhoea, is perfectly understood by the 
experienced physician, for the facial expressions, state of mind, 
and movements of the body, ail unconsciously betray, and 
unitedly proclaim, his condition. MEDICAL DIAGNOSIS. 
397 
697. Tongue. Much may be learned from the appearance, 
color, and form of the tongue, and the manner of its protrusion. 
If pale, moist and coated white, it indicates a mild, febrile 
condition of the system. If coated in the center, and the 
sides look raw, it indicates gastric irritation. If red and 
raw, or dry and cracked, it means inflammation of the mu- 
cous membrane of the stomach. If the inflammation be in 
the large intestine, the tip of the tongue presents a deep red 
color, while the center is loaded with a dark brown coating. 
When the tongue is elongated and pointed, quickly protruded 
and withdrawn, it indicates irritation of the nerve-centers, as 
well as of the stomach and bowels. If tremulous, it denotes 
congestion and lack of functional ability; this may be observed 
in congestive fevers. 
698. Pulse. Usually the pulse beats five times during one 
respiration, but both in health and disease its frequency may be 
accelerated or retarded. In adults, there are from sixty-five to 
seventy-five beats in a minute, and yet in a few instances we 
have found it, in health, when there were only forty pulsations 
per minute. But when it beats one hundred and twenty to one 
hundred and forty, it justifies an apprehension of danger, and 
the case should receive the careful attention of a physician. 
699. Irregularity of the pulse may be caused by disease of the 
brain, heart, stomach and liver; by the disordered condition of 
the nervous system; by lack of muscular nutrition, as in gout, 
rheumatism, convulsions; by deficiency of the heart’s effective 
power, when the pulse-wave does not reach the wrist, or when it 
intermits and then becomes more rapid in consequence of septic 
changes of the blood, as in diphtheria, erysipelas, and eruptive 
fevers. 
'700. Paill. The import of pain is according to its seat, 
intensity, nature, duration, etc. An acute, intense pain indicates 
inflammation of a nerve as well as the adjacent parts. Sharp, 
shooting, lacerating pains occur in inflammation of the serous 
tissues, as in pleurisy. A smarting, stinging pain attends inflam- 
mation of the mucous membrane. Acute pain is generally 
remittent and not fixed to one spot. Dull, heavy pain is more 
persistent, and is present in congestions, or when the substance 
of an organ is inflamed, and it often precedes hemorrhage, 398 
COMMON SENSE MEDICAL ADVISEE. 
(bleeding). Burning pain characterizes violent inflammations 
involving the skin and subjacent cellular tissue—as in case of 
boils and carbuncles. Deep, perforating pain accompanies 
inflammation of the bones, or of their enveloping membrane. 
Gnawing, biting, lacerating pain attends cancers. 
701. The location of pain is not always at the seat of the dis- 
ease. In hip-disease, the pain is not first felt in the hip, but in 
the knee-joint. In chronic inflammation of the liver, the pain 
is felt in the right shoulder and arm. Disease of the heart and 
pericardium is sometimes indicated by pain at the wrist and 
elbow-joint of the left arm. Disease of the kidneys occasionally 
produces numbness of the thigh and drawing up of the testicle, 
and commonly causes colic pains. Inflammation of the brain is 
indicated by nausea and vomiting before attention is directed to 
the head. These illustrations are sufficient to show that pain 
often takes place in some part remote from the disease. 
702. In chronic abdominal affections, rheumatic fevers, gout, 
syphilis, etc., the whole system is thrown into a morbid state, 
the nervous system is disturbed and wandering pains manifest 
themselves in different parts of the body. Fixed pain, which is 
increased by pressure, indicates inflammation. If it be only 
irritation, pressure will not increase it. Some rheumatic affec- 
tions and neuralgia, will not only bear pressure, but the pain 
will diminish under it. Permanent pain shows that the struc- 
tures of an organ are inflamed, while intermittent pain is a 
sign of neuralgia, gout or rheumatism. Absence of pain in any 
disease, where ordinarily it should be present, is an unfavorable 
sign. Internal pain, after a favorable crisis, is a bad omen. Or 
if pains cease suddenly without the other symptoms abating, the 
import is bad. If, however, pain and fever remit simultaneously 
and the secretions continue, the sign is favorable. 
703. A dull pain of the head indicates fullness of the blood- 
vessels from weakness, low blood or general debility. It may be 
caused by taking cold, thus producing passive congestion of the 
brain. It may proceed from gastric disturbance, constipation 
of the bowels or derangement of the liver. Heaviness of the 
head sometimes precedes inflammation of the brain, or chronip 
disease of its membranes. A dull, oppressive pain of the head 
indicates softening of the brain, and is generally accompanied by MEDICAL DIAGNOSIS. 
399 
slowness of the pulse and of the speech. A pulsating pain of the 
head occurs in heart disease, hysteria, and frequently accompanies 
some forms of insanity. 
704. The Eye indicates morbid changes and furnishes un- 
mistakable signs of disease. Sinking of the eye indicates morbid 
waste—as in consumption, diarrhoea and cholera. In fevers it is 
regarded as a fatal token. A dark or leaden circle around the 
eye, seen after hard work, indicates fatigue and overdoing. If 
the mucous covering of the inner surface of the lids and of the 
ball of the eye (conjunctiva) be congested and inflamed, it ex- 
hibits redness, and may indicate congestion or even inflammation 
of the brain. 
705. A dilated pupil will often be noticed in bronchial con- 
sumption, congestion of the brain, low fevers and chlorosis. 
The pupil contracts in inflammation of the brain, when there 
is increased sensibility and intolerance of light; also in spinal 
complaints. In some diseases the lustre of the eye increases— 
as in consumption, inflammation of the brain and apoplexy. But 
if it decreases at the attack of violent disease, it indicates great 
debility and prostration. 
706. Examination of the Urine. All medical 
authors, physicians of note, and professors in our different schools 
of medicine, freely admit, and even insist upon the importance of 
critically examining the patient’s urine, in order to determine the 
nature, location and exact condition of the disease. In chronic 
affections it is particularly serviceable, especially in derange- 
ments of the liver, blood, kidneys, bladder, prostrate gland and 
nervous system. Many scholarly physicians have sadly neglected 
the proper inspection of the urine, because they were afraid of 
being confounded with the illiterate “ uroscopian ” doctors, or 
fanatical enthusiasts, who ignorantly pretend to diagnose cor- 
rectly all diseases in this manner, thus subjecting themselves and 
their claims to ridicule. No false modesty should deter us from 
giving to this excretion the attention it deserves. 
707. The urine, voided when the system is deranged or dis- 
eased, will be altered in its color and composition, showing that 
its ingredients vary widely, from simple elements to organic com- 
pounds. Then it is examined as to its specific gravity, and the 
Urinometer indicates its density. Then follow the tests of its 400 
COMMOX SEXSE MEDICAX, ADVISER. 
acid or alkaline condition, to determine what acids or what al- 
kalies are present. Then the Microscope will reveal the presence 
of blood, or sperm, or kidney cells, and sometimes disclose the 
true nature of the deposit. So important an aid do examinations 
of the urine furnish in diagnosing many chronic ailments, that, 
at the World’s Dispensary, where many thousand cases are an- 
nually treated, a skillful chemist is employed, who makes a 
specialty of examining the urine and reporting the result to the 
attending physicians. His extended experience and familiarity 
with these experiments render his services invaluable. With his 
assistance, ofttimes maladies which had hitherto baffled all ef- 
forts put forth to determine their true character, have been 
quickly and unmistakably disclosed. 
Vos. Microscopical Examiiiatioai. This method 
of examination, although it requires more time to become expert, 
affords a quicker and more correct idea of a deposit or deposits 
than any other method. The expert, by simply looking at a speci- 
men,can often determine the character of the urine,whether blood, 
mucous, pus, bile, uric acid, etc., are present or not. But when 
no deposit is present, then it is necessary to apply chemical tests, 
and in many cases the quantity of the suspected ingredient must 
be determined either by approximative or quantitative analysis. 
As a detailed account of the various modifications which the 
urine undergoes in different diseases, would be of no practical 
use to the masses, as they could not avail themselves of the ad- 
vantages which it would afford for correct diagnosis, except by 
the employment of a physician who does not ignore this aid in 
examining his patients, I shall omit all further details on the 
subject. For the same reason I shall not often, in treating of the 
different diseases in which examinations of the urine furnish such 
valuable aid to correct diagnosis, make mention of the changes 
that are likely to have occurred. 
INFLAMMATION. 
709. The term Inflammation is descriptive of the state of a 
part when it is hotter, redder, more congested and more painful 
than is natural. Inflammation is limited to certain parts, while 
fever influences the system generally. Inflammation gives rise 
to new formations, morbid products, and lesions or alterations of INFLAMMATION. 
401 
structure. The morbid products of fever, and its modification 
of fluids are carried away by the secretions and excretions. 
710. The susceptibility of the body to inflammation may be 
natural or acquired. It is natural when it is constitutional; that 
is, when there is an original tendency of the animal economy to 
manifest itself in some form of inflammation. We may notice 
that some children are far more subject to boils, croups and 
erysipelous diseases, than others. This susceptibility, when 
innate, may be lessened by careful medication, although it may 
never be wholly eradicated. When acquired, it is the result of 
habits of life, climate, and state of the mind over the constitution. 
711. Phlegmonous inflammation is the active inflaming of 
the cellular membrane, one illustration of which is a common 
boil. The four principal symptoms are redness, swelling, heat 
and pain, and then appears a conical, hard, circumscribed tumor, 
having its seat in the dermoid texture. At the end of an inde- 
finite period, it becomes pointed, white or yellow, and gives exit 
to pus mixed with blood. When it breaks, a small, grayish, 
fibrous mass sometimes appears, which consists of dead cellular 
tissue, and is called the core. 
712. There are certain morbid states of the constitution which 
lead to local inflammation, subsequent upon slight injury; or, in 
some cases, without any such provocation, as instanced by gout, 
rheumatism, scrofula, etc. When considering the encephalic 
temperament, I dwelt upon its strong and persistent tendencies 
to drain away the vital energies from the bodily functions. (T 159 
and 227.) One of the first results is to weaken the forces which 
distribute the blood to the surface and extremities of the body. 
It is generally admitted that in scrofulous persons the vascular 
system is weak, the vessels are small, and because nutrition is 
faulty, the blood is imperfectly organized. The result is failure 
in the system, for if nutrition fails, there may be lacking earthy 
matter for the bones, or the unctious secretions of the skin: the 
sebacious secretion is albuminous and liable to become dry, 
producing irritation of the parts which it ought to protect. 
713. Disorder of the alimentary canal and other mucous sur- 
faces are sometimes reflected upon the skin. I have occasionally 
observed cuticular eruptions and erysipelas, when evidently they 
were distinct signs of internal disorder. 402 
COMMON SENSE MEDICAL ADVISEE. 
714. Inflammation may be internal as well as external, as 
inflammation of the brain, lungs, stomach, etc., and it is fre- 
quently the result of what is called taking cold. No matter 
how the body is chilled, the blood retreats from the surface, 
which becomes pale and shrunken, there is also nervous uneasi- 
ness and oftentimes a rigor, accompanied with chattering of the 
teeth. After the cold stage, reaction takes place and fever fol- 
lows. The sudden change from a dry and heated room to a cool 
and moist atmosphere is very liable to induce a cold. Riding 
in a carriage until the body is shivering, or sitting in a draft of 
air when one has been previously heated, or breathing a very 
cold air during the night when the body is warm, especially 
when not accustomed to doing so, or exposing the body to a low 
temperature when insufficiently clothed, are all different ways 
for producing inflammation. 
715. Inflammation may result in consequence of local injury, 
as from a bruise, or by a sharp cutting instrument, as a knife or an 
axe, or it may be caused by the puncture of a pin, pen-knife blade 
or a fork-tine, or from a lacerated wound, as from a bite of a dog, 
or from a very minute wound poisoned by the bite of a venomous 
reptile. Local inflammations may arise from scalds, burns, 
application of caustics, arsenic, corrosive sublimate, cantbarides, 
powerful acids, abrasions of the surface by injuries and from 
the occurrence of accidents. 
716. The swelling of the part may be caused by an increase 
of the quantity of blood in the vessels, the effusion of serum 
and coagulating lymph, and the interruption of absorption by 
the injury, or by the altered condition of the inflamed part. 
717. The character of the pain depends upon the tissue in- 
volved, and upon the altered or unnatural state of the nerves. 
Ordinarily, tendon, ligament, cartilage, hone, etc., are not very 
sensitive, but when inflamed they are exquisitely impressible. 
The heat of the inflamed part is not so great, when measured 
by the thermometer, as might be supposed from the patient’s 
sensations. 
718. Termination of InHannnation. Every 
one is interested to know how inflammation may end, especially 
if he happens to he suffering from an attack. It will end in one 
of six different ways. It may terminate in resolution, i. e FEVER, 
spontaneous recovery, by suppuration, in the formation of mat- 
ter, by effusion, as the inflammation caused by a blister plaster 
terminates by effusion of water, by adhesion, the part inflamed 
forming an attachment to some other part, by induration, 
hardening of the organ, or by gangrene, that is, death of the 
part. 
719. Thus inflammation of the lungs may terminate by 
recovery, that is, by resolution, by adhesion to the pleura, by 
suppuration and raising of matter, by hardening and solidifying 
of the lung, or by gangrene. Inflammation of the heart may 
thicken its walls or ossify its valves; inflammation of the peri- 
cardium (heart case) may terminate in effusion (dropsy), and 
inflammation of the liver may result in hardening and adhering 
to adjacent parts. 
GENERAL PRINCIPLES FOR TREATMENT OF INFLAMMATION. 
720. Remove the exciting causes as far as practicable. If 
caused by a splinter or any foreign substance, it should be 
withdrawn, and if the injury is merely local, apply cold water to 
the parts to keep back the inflammation. If caused by a rabid 
animal, the wound should be enlarged and cupped, and the parts 
cleansed or destroyed by caustic. The patient should remain 
quiet and not be disturbed. The use of tincture of veratrum 
597) internally, will be found excellent to prevent the rise of 
inflammation. A purgative is also advised, and four or five of 
my Pleasant Purgative Pellets will be sufficient to act upon the 
bowels. If there is pain, an anodyne and diaphoretic is proper. 
My Compound Extract of Smart-Weed will fulfill this indication. 
In local inflammation cold water is a good remedy, yet some- 
times hot water, or cloths wrung out of it, will be found to be 
the appropriate application. When the inflammation is located 
on an organ within a cavity, as the lungs, hot fomentations will 
be of great service. Bathing the surface with alkaline water 
must not be omitted. Whenever the inflammation is serious the 
family physician should early be summoned in attendance. 
FEVER. 
721. In fever all the functions are more or less deranged. In 
every considerable inflammation there is sympathetic fever, but 404 
COMMON SENSE MEDICAL ADVISEE. 
in fevers proper there are generally less lesions of structure than 
in inflammation. Fever occasions great waste of the tissues of 
the body, and the refuse matter is carried away by the organs of 
secretion and exci’etion. The heat of the body in fever is gener- 
ally diffused, the pulse is quickei’, there is dullness, lassitude, 
chilliness and disinclination to take food. I intend to give only 
the general outline of fevers, enough to indicate the principles to 
be observed in domestic treatment. 
722. Most fevers are very distinctly marked by four stages: 
1st, the forming stage; 2d, the cold stage; 3d, the hot stage; 
4th, the sweating or declining stage. During the first stage the 
individual is hardly conscious of being ill, for the attack is so 
slight that it is hardly perceptible. True, as it progresses, there 
is a feeling of languor, an indisposition to make any bodily or 
mental effort, and also a sense of soreness of the muscles, aching of 
the bones, chilliness, and a disposition to get near the fire. There 
is restlessness, disturbed sleep, bad dreams, lowness of spirits, 
all of which are characteristic of the forming stage of fever. 
723. The next is the cold stage, when there is a decided 
manifestation of the disease, and the patient acknowledges that 
he is really sick. In typhus and typhoid fever the chills are 
slight; in other fevers they are more marked; while in ague they 
are often accompanied by uncontrollable shaking. When the 
chill is not so distinct the nails look blue and the skin appears 
shriveled, the eye is sunken and a dark circle circumscribes it, the 
lips are blue, and there is pain in the back. The pulse is frequent, 
small and depressed, the capillary circulation feeble, the respir- 
ation increased, and there may be nausea and vomiting. These 
symptoms vary in duration from a few minutes to more than an 
hour. They gradually abate, reaction takes place, and the 
patient begins to throw off the bedclothes. 
724. Then follows the hot stage, for with the return of the 
circulation of the blood to the surface of the body, there is 
greater warmth, freer breathing, and a more comfortable and 
quiet condition of the system. The veins fill with blood, the 
countenance brightens, the cheeks are flushed, the intellect is 
more sprightly, and if the pulse is frequent, it is a good sign; if 
it sinks, it indicates feeble vital force, and is not a good symp- 
tom. If there is considerable determination of blood to the head, FEVER 
405 
it becomes hot, the arteries of the neck pulsate strongly, and we 
may expect delirium. During the hot stage, if the fever runs 
high, the patient becomes restless, frequently changes his position, 
is wakeful, uneasy and complains of pain in his limbs. In low 
grades, the sensibility is blunted, smell, taste and hearing, being 
impaired. 
The patient in the hot stage is generally thirsty, and if he is 
allowed to drink much, it may result in nausea and vomiting. 
Moderate indulgence in water, however, is allowable. There is 
aversion to food, and if any is eaten, it remains undigested. The 
teeth are sometimes covered with dark sordes (foul accumula- 
tions) early in the fever, and the appearance of the tongue varies, 
sometimes coated a yellowish brown, sometimes red and dry, at 
other times it is thickly coated white. The condition of the 
bowels varies from constipation to diarrhoea, although some- 
times they are quite regular. The urine is generally diminished 
in quantity, but shows higher color. 
725. The sweating stage in some fevers is very marked, while 
in others there is very little moisture, but an evident decline 
of the hot stage, the skin becoming more natural and soft. 
The pulse is more compressible and less frequent, the kidneys act 
freely, respiration is natural, the pains subside, although there 
remains languor, lassitude and weariness, a preternatural sensi- 
bility to cold, an easily excited pulse, and a pale and sickly 
aspect to the countenance. The appetite has failed and the 
powers of digestion are still impaired. 
726. Domestic Management ©f Fevers. It is 
proper to make a thorough study of the early, insidiously invad- 
ing symptoms of fever, in order to understand what may be 
safely done. If it arises in consequence of malaria, the treatment 
must be suited to that circumstance. If from irritation of the 
bowels and improper articles of diet, then a mild cathartic is 
required. If there is much inflammation, a severe chill and 
strong reaction, then the treatment should be active. If the 
fever is of the congestive variety and attacks a feeble constitu- 
tion, reaction imperfect, small and weak pulse, tendency to 
fainting, countenance pale, and deep pain in the head, estab- 
lish warmth and sweating, and procure the services of a good 
physician. 406 
COMMON SENSE MEDICAL ADVISER. 
727. As a general rule, it is proper to administer a cathartic, 
unless in typhoid fever, and for this object my Purgative Pellets 
answer the purpose, giving for a dose from four to six, according 
to the state of the bowels. If these are not at hand, a tea of 
sage and senna may be drank, until it produces a purgative effect. 
In nearly all fevers, I have found that a weak alkaline tea, 
made from the white ashes of hickory or maple wood, is useful, 
taken weak, three or four times daily, or if there be considerable 
thirst, more frequently. Some patients desire lemon juice, which 
has an alkaline base, and may answer all purposes. 
Diaphoretic medicines are also indicated, and the use of my 
Extract of Smart-Weed will prove very serviceable. Drinking 
freely of pleurisy-root tea 550), or of a strong decoction of 
boneset 498) is very useful. The latter, if taken in sufficient 
quantities, may act very favorably as an emetic. After free 
sweating has been established, then it is proper to folloiv by the 
use of diuretic teas, such as spearmint and pumpkin seeds com- 
bined, or sweet spirits of nitre, in doses of twenty to thirty drops, 
added to a teaspoonful of the Extract of Smart-Weed, diluted 
with sweetened water. 
728. To lessen the frequency of the pulse, fluid extract or 
tincture of veratrum 597) or aconite 596) may be given 
in water, every hour. During the intermission of symptoms, 
tonic medicines and a sustaining course of treatment should be 
employed. If the tongue is loaded and the passages from the 
bowels are fetid, a solution of sulphite of soda 474) is proper; 
or, take equal parts of brewer’s yeast and water, mix, and when 
the yeast settles, give a tablespoonful of the water every hour, 
as an antiseptic. Administering a warm, alkaline hand-bath to 
a fever patient every day, is an excellent febrifuge remedy, being 
careful not to chill or induce fatigue. If there is pain in the 
head, apply mustard to the feet; if it is in the side, apply hot 
fomentations. 
729. The symptoms that indicate danger are, a tumid and 
hard abdomen, difficult breathing, offensive and profuse diarrhoea, 
bloody urine, delirium or insensibility. Favorable symptoms 
are, a natural and soft state of the skin, eruptions on the sur- 
face, a natural expression of the countenance, moist tongue, 
free action of the kidneys and regular sleep. If the domestic FEVER AND AGUE. 
407 
treatment which I have advised does not break the force of the dis- 
ease and mitigate the urgency of the symptoms, it will be safer 
to employ a good physician, who will prescribe such a course of 
treatment as the case specially requires. It is my aim to indi- 
cate what may be done before the physician is called, for many 
times his services cannot be obtained when they are most 
needed. Besides, if these attacks are early and properly treated 
with domestic remedies, it will oftentimes obviate the necessity 
of calling upon a physician. If, on the other hand, fevers are 
neglected and no treatment instituted, they become more serious 
in character and are more difficult to cure. 
730. To recapitulate, my treatment recommends evacuation 
through nature’s outlets — the skin, kidneys and bowels — 
maintaining warmth, neutralizing acidity, using antiseptics, 
tonics and the hand-bath, and the fluid extract or tincture of 
veratrum, or aconite, to moderate the pulse by controlling the 
accelerated and unequal circulation of the blood. It is a simple 
treatment, but if judiciously followed, will often prevent a run 
of fever, or materially modify its intensity and shorten its course. 
731. The description of fever already given applies well to 
this form of it, only the symptoms in the foi’mer stage are 
rather more distinct than in the other varieties. Weariness, 
lassitude, yawning and stretching, the bitter taste of the mouth, 
nausea, loss of appetite, the uneasy state of the stomach and 
bowels are more marked in the premonitory stages of intermit- 
tent fevers. The cold stage commences with a chilliness of the 
extremities and back, the skin looks pale and shriveled, the 
blood recedes from the surface, respiration is hurried, the urine 
is limpid and pale, sometimes there is nausea and vomiting, and 
towards the conclusion of the stage, the chilly sensations are 
varied with flushes of heat. The hot stage is distinguished by 
the heat and dryness of the surface of the body and the red- 
ness of the face; there is great thirst, strong, full and hard 
pulse, free and hurried respiration and increased pain in the 
head and back. The sweating stage commences by perspiration 
appearing upon the forehead, which slowly extends over the 
whole body, and soon there is an evident intermission of all the 
FEVER AND AGUE. (Intermittent Fever.) 408 
COMMON SENSE MEDICAL ADVISER. 
symptoms. In the inflammatory variety of intermittent fever, 
all these symptoms are acute, short and characterized by strong 
reaction. The congestive variety is known by tedious chills, 
feeble reaction, and small, weak pulse. Gastric intermittents are 
marked by irritation of the stomach and bowels, and a yellow 
appearance of the white of the eye, and is the most frequent 
variety. Malignant intermittents are distinguished by an exag- 
geration of all the symptoms, as copious, fetid sweats, frequent 
hemorrhages, etc. They run their course rapidly, and most 
generally occur in warm climates. 
732. Causes. The exciting cause is supposed to be mal- 
aria, a poisonous, gaseous exhalation from decaying vegetation 
and from swamps and marshes, which is absorbed into the sys- 
tem through the lungs. 
733. Treatment. First administer an energetic cathar- 
tic—from four to six of the Purgative Pellets will generally be 
sufficient. Then if the patient feels cold, give him the Extract 
of Smart-Weed in pleurisy-root or pennyroyal tea. Then fol- 
low, during the intermission of symptoms, with antiperiodics, 
administering the Golden Medical Discovery as directed in 
Administer a hot foot-bath; also, bathe the surface of the body 
in water rendered alkaline by the addition of salseratus or baking 
soda. If the attack is very severe and is not relieved by this 
treatment, a physician should be summoned to attend the case. 
BILIOUS FEVER. (Remittent Fever.) 
734. The distinction between intermittent and remittent fever 
does not consist in a difference of origin. In the former disease 
the symptoms completely intermit/ in the latter they only partly 
remit. 
735. Treatment. Administer an alkaline sponge-bath; 
give the Extract of Smart-Weed and sweating teas—as 
ginger, catnip, etc. Use my Purgative Pellets to act upon 
the bowels, and when the time for a remission of symptoms 
approaches, give the Golden Medical Discovery, as directed for 
fever and ague. To equalize and control the circulation, tinc- 
ture of the fluid extract of veratrum 597) should be adminis- 
tered. If the fever subsides and perspiration occurs, it is an 
indication favorable to the recovery of the patient. Should the TYPHUS FEVER. 
409 
course of treatment here advised not promptly arrest the disease, 
the family physician should be summoned. 
736. The symptoms of these fevers do not intermit and remit, 
but their phenomena continue without any such variation. They 
are usually characterized by greater prostration of the system, 
and are called putrid when they manifest septic (destructive) 
changes in the fluids; congestive when the blood accumulates 
upon the internal organs, and malignant when they speedily run 
to a fatal termination. Typhoid and typhus fever belong to the 
class of continued fevers. I will not advise treatment for these 
more grave disorders which should always, for the safety of the 
patient, be attended by the family physician, except to call at- 
tention to some simple means that may be employed in the 
initial stage of the disease, or when a physician’s services cannot 
be promptly secured. 
CONTINUED FEVER. 
TYPHOID FEVER. (Enteric Fever.) 
737. In typhoid fever there is disease of the intestines and 
mesenteric glands, very liable to terminate in ulceration. This 
diseased condition of the bowels distinguishes this fever from all 
others, and is readily detected by sensitiveness to pressure, es- 
pecially on each side of the abdomen. The early disposition to 
diarrhoea is another characteristic symptom of it, and there 
is also no remission of febrile indications, as in bilious fe.ver. 
This dangerous fever is clearly marked by all these distinguishing 
symptoms and its remedial treatment should at once be confided 
to the family physician. 
TYPHUS FEVER. 
*738. In typhus fever there is more capillary congestion than 
in typhoid, consequently the face in the early stage presents a 
dusky or more dingy hue. The white of the eye is congested 
and looks red, the countenance is expressionless, there is delirium 
also, and the tongue is loaded with a darker coating than in ty- 
phoid fever. Typhus fever is contagious, whereas typhoid is not 
so likely to be communicated. Typhoid fever is characterized 
by abdominal disease, whereas in typhus there is none. I 410 
COMMON SENSE MEDICAL ADVISEE. 
would not recommend any treatment except referring to that 
indicated under general directions, but advise the early attend- 
ance of the family physician. 
739. Eruptive fevers are characterized by a rash, or a more 
distinct vesicular or pustular eruption, as in chicken-pox or small- 
pox. Each is a distinct species of fever, and all are capable 
of being communicated except those called rose-rash, and 
erysipelas. 
ERUPTIVE FEVERS. 
SCARLET FEYER. (Scarlatina.) 
740. This fever takes its name from the scarlet color of the 
eruption on the surface of the body. Sometimes it is compara- 
tively mild and is then called Scarlatina Simplex/ when it is 
accompanied by a sore throat it is termed Scarlatina Anginosa/ 
and when the disease is intense and dangerous, it is called 
Scarlatina Maligna. Three distinct stages may be noticed: (1), 
Invasion; (2), Eruption; and (3), Desquamation. In the stage 
of invasion there is pain in the head, increased heat ot the skin, 
redness and soreness of the throat, and sometimes nosebleed, diar- 
rhoea or vomiting. The average duration of this stage is twenty- 
four hours. The eruptive stage generally begins on the second 
day, though sometimes it is delayed longer, and the scarlet rash 
rapidly diffuses itself over the whole body. The redness is vivid 
and has been compared to the appearance of a boiled lobster. 
The stage of eruption reaches its maximum of intensity on the 
third day, and it is important that it does not recede. Redness 
of the tonsils and throat is one of the early symptoms which pre- 
cedes any cutaneous eruption. The tongue also is finely spotted 
with numerous red points which mark its papillae. 
741. The thirst is urgent, there is no appetite, and vomiting 
and mild delirium are common. This stage continues from four to 
six days, though sometimes it is longer. Desquamation (sealing 
off) of the skin commences at the decline of the eruption, in the 
form of minute, branny scales. The duration of this stage is 
indefinite, and may end in five or six or may continue ten or 
twelve days. 
'742. If the inflammation in the throat is very severe, it may SMALL-POX. 
411 
terminate in suppuration, which may also occur in the glands of 
the neck, and sometimes the inflammation extends to the lips, 
cheeks and eyelids. Gangrene within the throat is rare. The 
disease is easily communicated, and the attack will usually follow 
the exposure in two or three days. It occurs most frequently in the 
third and fourth years of life. There is no other disease so simple, 
and yet so often liable to prove fatal, as scarlet fever; and for 
this reason I shall advise the attendance of the family physician. 
743. Domestic treatment may be given as follows, until the 
physician can be obtained. Warm alkaline baths are proper, 
and catnip, pennyroyal or pleurisy-root tea, containing one tea- 
spoonful of my Extract of Smart-Weed, should be given, to drive 
the rash to the surface. A mild alkaline drink is suitable to 
allay the thirst, nausea and fever. A tepid bath, twice a day, is 
good. In some cases the wet sheet pack is invaluable. Three 
drops of the fluid extract of belladonna in two ounces of water, 
is said to be a preventive of scarlet fever. A teaspoonful should 
be given twiee a day. I would again remind parents that this 
disease is one that requires the attendance of the family physician, 
and great care should be exercised during recovery, that no bad 
results follow it. 
SMALL-POX. (Variola.) 
'744. There are a variety of eruptive fevers, each one of 
which is distinct and propagated by causes reproduced within 
the body. The most formidable of these communicable diseases 
is sinall-pox, and this cannot be distinguished from others of 
the class before the development of its vesicles, which are 
granular, hard and deep-seated. There are two varieties of this 
disease, known as confluent and distinct variola; in the former, 
the vesicles run together, in the latter, they are separate. 
This fever has three stages: The first is that of invasion, dis- 
tinctly marked by a chill or a series of chills, which alternate 
with flushes of heat. In this stage the tongue becomes coated, 
there is also nausea and vomiting, pain in the limbs, back and 
particularly in the loins, the latter symptom being of diagnostic 
importance. This stage continues about two days, and if the 
symptoms are mild, it may be expected that the disease will be 
comparatively mild, and of the distinct variety. 412 
COMMON SENSE MEDICAL ADVISER. 
Stage of Eruption. The eruption begins to appear on the 
skin, generally on the third day following the attack, though in 
the throat and mouth may be discovered round, whitish or ashy 
spots sevei-al hours previous to the manifestation of vesicles on 
the surface of the body. These are first seen on the face and 
neck, then on the trunk and upper exti’emities, and lastly, on the 
lower extremities. The eruption at first appears in the form of 
small red or purple spots, which change the texture of the skin 
by becoming more hard, pointed and elevated. On the fifth day 
of the eruption they attain their full size, being softened and 
depressed in the center, and hence are called umbilicated. 
Now a change takes place, and the vesicles fill with matter and 
become pointed and there is a rise in the fever. 
The stage of suppuration commences thus: The pulse quick- 
ens, the skin becomes hotter, and in many cases of the confluent 
variety, swelling of the face, eyelids and extremities occurs. 
Frequently there is passive delirium in this stage, and if diarrhoea 
sets in, it is an unfavorable sign. The duration of this stage of 
the eruption is four or five days. 
The stage of desiccation, which means the drying of the pus- 
tules, commences between the twelfth and fourteenth day of the 
disease. In the confluent variety patches of scab cover all the 
space occupied by the disease, and sometimes the whole face looks 
hideous in this scaly mask. The skin exhales a sickening odoi*, 
and as the scabs fall off, there is great liability to leave “ pock- 
marks.” Small-pox is attended with a great deal of danger, as 
one out of four cases terminates fatally. 
745. Treatment should have reference to determin- 
ing the eruption to the surface. If there is thirst, allow cold 
drinks, ice-water or lemonade. Bathing the surface with cold 
water, allowing plenty of fresh air, using disinfectants in the 
room and taking antiseptic medicine internally, is proper. Add 
one part carbolic acid to six parts glycerine, mix from two to 
three di-ops of this with an ounce of water, and when thus pre- 
pared, take teaspoonful doses frequently. A few di’ops of 
carbolic acid and glycerine may be rubbed with lard and the 
surface anointed with it to pi'event pitting. The malady is so 
grave that it should be entrusted to the care of the family 
physician. VACCINIA. 
413 
VARIOLOID. (Modified Small-Pox.) 
746. Small-Pox is materially modified by inoculation, and 
also by vaccination; the latter generally serves as a complete 
protection against it. Varioloid is neither more nor less than 
variola, modified. Inoculation is produced by using the matter 
from a small-pox patient and thus infecting another’s blood with 
the disease. Inoculated sinall-pox is much less severe. The 
pocks rarely exceed one hundred; there is less constitutional 
disturbance; very little or no pitting of the skin; and it serves 
as a complete protection against small-pox. When the vaccine 
matter of cow-pox does not completely exempt the person from 
small-pox, the resulting illness is also called varioloid. A 
person suffering from either of these modifications of the 
disease will, by contagion, communicate to another genuine 
sinall-pox. The treatment is the same as that recommended in 
variola. 
747. The important discovery of vaccination is due to Dr. 
Jenner, who ascertained that when the cow was affected by this 
disease and it was then communicated to man, that the disease 
was rendered very mild and devoid of danger, and at the same 
time it proved a very complete protection against small-pox. 
Like most other valuable discoveries introduced to the world, 
it encountered bitter prejudice and the most unfair opposition. 
Now its inestimable value is generally known and admitted. 
VACCINIA. (Cow-Pox.) 
In a few cases, where the quality of the vaccine virus has dete- 
riorated, its effect is only to slightly modify small-pox, and then 
the disease resembles that caused by inoculation. The operation 
of infecting the blood with the Jcine virus is called vaccination. 
All that we know is that when the cow becomes affected with 
this disease, and it is then transferred to man, it loses its severity 
and serves as a protection against small-pox. In a great majority 
of cases this protection is absolute, and only in a small minority 
does it leave them susceptible to small-pox, materially modified. 
The protection it affords against small-pox is found to diminish 
after the lapse of an indefinite number of years, and hence it is 
important to be re-vaccinated once or twice, say after an interval 
of five years. Between the second and third months of infancy 414 
COMMON SENSE MEDICAL ADVISER. 
is the best period for vaccination, and the place usually selected 
is the middle of the arm above the elbow-joint. 
748. Chicken-Pox is an eruptive disease which affects chil- 
dren, and occasionally adults. It is attended with only slight 
constitutional disturbance, and is therefore neither a distressing 
nor dangerous affection. The eruption first appears on the body, 
afterwards on the neck, the scalp, and lastly on the face. It ap- 
pears on the second or third day after the attack, and is succeeded 
by vesicles containing a transparent fluid. These begin to dry 
on the fifth, sixth or seventh day. This disease may be distin- 
guished from variola and varioloid by the shortness of the period 
of invasion, the mildness of the symptoms and the absence of the 
deep, funnel-shaped depression of the vesicles, so noticeable in 
variola. 
CHICKEN-POX. (Varicella.) 
749. TreatmeBlt. Ordinarily very little treatment is 
required. It is best to use daily an alkaline bath, and as a drink, 
the tea of pleurisy-root, catnip or other diaphoretics, to which is 
added from half to a teaspoonful of my Extract of Smart-Weed. 
If the fever runs high, a few drops of aconite in water will con- 
trol it. 
MEASLES. (Rubeola.) 
750. This would be a disease of less severity and importance 
than the other eruptive fevers, were it not sometimes followed 
by serious results. The stage of invasion is marked by the 
symptoms of a common cold, sneezing, watery eyes, discharge 
from the nostrils, dry cough, and the patient complains of being 
chilly. This stage may last four days. Then follows an erup- 
tion of red dots or specks, which momentarily disappear on 
pressure. On the fourth day of the eruption the redness of the 
skin fades, the fever diminishes and the vesicles dry into scales 
or little flakes. The eyes may be inflamed and the bowels may 
be quite lax at this stage. 
751. Treatment. The great object in treatment is to 
determine the disease to the surface. To effect this, sweating 
teas are proper. The free use of my Extract of Smart-Weed is 
recommended, and the skin should be bathed every day with a ERYSIPELAS. 
415 
warm,alkaline bath. Sometimes, when warm drinks fail in bring- 
ing out the eruption, drinking largely of cold water and keeping 
warmly covered in bed, will accomplish it. 
752. False Measles {Rose-Rash) is an affection of very 
little importance and may be treated as we would a case of or- 
dinary measles. 
ERYSIPELAS. 
753. There are few adult persons in this country who have 
not, by observation or experience, become somewhat familiar 
with this disease. Its manifestations are both constitutional and 
local, and their intensity varies exceedingly in different cases. 
The constitutional symptoms are usually the first to appear and 
are of a febrile character. A distinct chill, attended by nausea 
and general derangement of the stomach is experienced, followed 
by febrile symptoms more or less severe. There are wandering 
pains in the body and sometimes a passive delirium exists. Sim- 
ultaneously with these symptoms the local manifestation of the 
disease appears. A red spot develops on the face, the ear, 
or other part of the person. Its boundary is clearly marked and 
the affected portion slightly raised above the surrounding sur- 
face. It is characterized by a burning pain and is very sensitive 
to the touch. It is not necessary for the benefit of the popular 
reader that I stop to distinguish between the different varieties 
of this malady. The distinctions made are founded chiefly upon 
the depth to which the morbid condition extends, and not on any 
difference in the nature of the affection. 
Suppuration of the tissues involved is common in the severer 
forms. Should the tongue become dark and diarrhoea set in, at- 
tended with great prostration of the patient’s strength, the case 
is very serious, and energetic means must be employed to save 
life. A retrocession of the inflammation from the surface to a 
vital organ is an extremely dangerous condition. 
The disease is not regarded as contagious, but has been known 
to become epidemic. 
754. Treatment. The treatment during the initial stage 
of this disease should correspond to the general principle laid 
down for the treatment of fever. The spirit vapor-bath, with 
warm diaphoretic teas, or my Compound Extract of Smart-Weed 416 
COMMON SENSE MEDICAL ADVISER. 
may be given to favor sweating. The whole person should be 
frequently bathed in warm water rendered alkaline by the ad- 
dition of salseratus or soda. The bowels should be moved by a 
full dose of my Purgative Pellets. Fluid extract of veratrum 
(f 597) in small and frequent doses, will best control the fever. 
The specific treatment—that which antidotes the poison in the 
blood, consists in administering five drop doses of the muriated 
tincture of iron 618) in one teaspoonful of my Golden Med- 
ical Discovery, every three hours. As a local application, the 
inflamed surface may be covered with cloths wet in the mucilage 
of slippery elm; or equal parts of sweet oil and spirits of tur- 
pentine, mixed and painted over the surface, is an application of 
unsurpassed efficacy. 
DIPHTHERIA 
755. This is an exceedingly grave constitutional malady, 
characterized by a rapid breaking down of the powers of life, 
together with a peculiar affection of the throat, in which a dis- 
position to the formation of false membranes is a prominent 
feature. The formation of these membranes, however, in this 
disease, is not limited to the throat, but may occur on mucous 
surfaces elsewhere. In this disease the local affection is but the 
expression of a specific morbid condition of the system, which 
closely resembles that present in the severer forms of scarlet 
fever. 
756. Cause. This is eminently an epidemic disease, and 
like other epidemics, has its special causes, though precisely 
what these are, has not been determined. It is also considered 
contagious. 
757. Symptoms. The symptoms vary in different cases. 
In some the disease comes on gradually, while in others it is 
malignant from the first. The throat feels sore, the neck is stiff 
and a sense of languor, lassitude, and exhaustion pervades the 
system. Sometimes a chill is experienced at the outset. Febrile 
disturbance, generally of a low typhoid character, soon mani- 
fests itself. The skin is hot; there is intense thirst; the pulse is 
quick and feeble, ranging from 120 to 150 per minute. The 
tongue is generally loaded with a dirty coat, or it may be bright 
red. The odor of the breath is characteristic, and peculiarly DIPHTHERIA. 
417 
offensive, and there is difficulty of swallowing and sometimes of 
breathing. Vomiting is sometimes persistent. If we examine 
the throat, wre find more or less swelling of the tonsils and sur- 
rounding parts, which are generally bright, red, and shining, 
and covered with a profuse, glairy, tenacious secretion. Some- 
times the parts are of a dusky livid hue, and sometimes, though 
rarely, palid. The false membrane, a peculiar tough exudation, 
soon appears and may be seen in patches, large or small, or 
covering the entire surface from the gums back as far as can be 
seen, its color varying from a whitish yellow to a gray or dark 
ashen tint. When it is thrown off, it sometimes leaves a foul, 
ulcerating surface beneath. The prostration soon becomes ex- 
treme, and small livid spots may appear on the surface of the 
body. There may be delirium, which is, in fatal cases, suc- 
ceeded by stupor (coma). The extremities become cold; diarrhoea, 
and in some cases convulsions, mark the approach of death. 
Sometimes the patient dies before the false membrane forms. 
758. Treatment. The extremely dangerous character 
of this disease demands that the service of a skillful physician be 
obtained at once; and that his efforts should be aided by the 
most thorough hygiene—good ventilation, bathing, supporting 
diet, etc. Prior to the arrival of the physician, lose no time in 
using the spirit vapor-bath 630) and hot foot-bath 640). 
If the former is impracticable, the latter is not. Get the patient 
into a perspiration, and maintain it. For this purpose, small 
doses of my Compound Extract of Smart-Weed may be given in 
some diaphoretic infusion, as pleurisy-root 550) or catnip 
549), repeated as often as the case demands. Also give small 
doses of veratrum 597) every hour, and thus modify the 
circulation. Control the vomiting and allay the thirst by allow- 
ing the patient to suck small pieces of ice every five or ten 
minutes. Hot fomentations 649) should be applied to the 
throat. If the physician does not take charge of the patient by 
this time, the throat should be swabbed out with the following: 
Take carbolic acid one part, glycerine six parts, water six 
parts; also add of this mixture twenty drops to a glass of water, 
and give of it, internally, one teaspoonful every two hours. In- 
haling steam from w*ater to which a few drops of the oil of 
peppermint has been added, is often serviceable, although some 418 
COMMON SENSE MEDICAL ADVISER. 
practitioners regard the vapor of alcohol as preferable. The use 
of blisters, caustics, active purges, mercurials or bleeding, is gen- 
erally condemned. Throughout the whole course of treatment, 
the strength must be supported by the most nourishing diet, as 
well as by tonics 607) and stimulants (1" 600). Beef tea, milk, 
milk punch, quinine and brandy, should be freely adminis- 
tered. Although I have given a very complete course of treat- 
ment, and one which has proved eminently successful in this 
disease, yet I would not advise any non-professional persons to 
rely upon any course of treatment not under the observation 
and direction of a competent physician, when one can be had. 
QUESTS Y. (Tonsilitis.) 
759. This is an acute inflammation of the tonsils, which gener- 
ally extends to, and involves adjacent structures, and is attended 
with general febrile disturbance. Its duration varies from four 
to twenty days. It sometimes terminates by a gradual return to 
health (resolution); or by the formation of matter wdthin the 
gland (suppuration). When this latter is the case, the swelling 
sometimes becomes so great before it breaks, as to require lan- 
cing. 
760. Causes. It most frequently results from a cold. In 
some persons there is a predisposition to it, and the individual is 
liable to recurring attacks. Persons of a scrofulous diathesis are 
more liable to it than others. 
761. Symptoms. Difficulty of swallowing, soreness and 
stiffness of the throat, are the first monitions of its approach. 
There is fever, quick, full pulse, and dryness of the skin; the 
tongue is furred, and the breath offensive. The tonsils are in- 
tensely red, swollen and painful, the pain often extending to the 
ear. Sometimes but one tonsil is affected, though generally both 
are involved. In severe cases the patient cannot lie down, in 
consequence of the difficulty of breathing. 
'762. Treatment. In the early stage of the disease the 
spirit vapor-bath 630) is invaluable. The sweating which it 
produces should be kept up by the use of my Compound Extract 
of Smart-Weed in some diaphoretic infusion. Hot, wet packs to 
the throat, covered with dry cloths, are useful. The inhalation 
of the hot vapor of water or vinegar* or peppermint and water, ENLARGED TONSILS. 
419 
is beneficial. A cathartic should be given at night. When the 
disease does not show a disposition to yield to this treatment, 
the services of a physician should be obtained. When matter is 
formed in the tonsil, which may be known by the increased 
swelling and the pointing of the abscess with a yellowish spot, 
the services of a physician will be required to lance it. 
ENLARGED TONSILS. 
763. Chronic enlargement of the tonsils, as shown in Fig. 146, 
a a, is an exceedingly common af- 
fection. It is most common to 
those of a scrofulous habit. It 
rarely makes its appearance after 
the thirtieth year, unless it has ex- 
isted in earlier life, and been im- 
perfectly cured. Both tonsils are 
generally, though unequally, en- 
larged. The person affected with 
this disease is extremely liable to 
sore throat, and suffers from the 
most trivial circumstances; expo- 
sure to cold, suppression of per- 
spiration, or derangement of the 
digestive apparatus being sufficient to provoke inflammation. 
Fig. lJf6. 
A A.—Enlarged Tonsils. B.—Elon- 
gated Uvula. 
764. Causes. Repeated attacks of quinsy, scarlet fever, 
diphtheria, or scrofula, and general impairment of the system, 
predispose the individual to this disease. 
765. Symptoms. The voice is often husky, nasal or 
guttural, and disagreeable. When the patient sleeps, a low 
moaning is heard, accompanied with snoring and stentorious 
breathing, and the head is thrown back so as to bring the 
mouth on a line with the windpipe, and thus facilitate the ingress 
of air into the lungs. When the affection becomes serious it 
interferes with breathing and swallowing. The chest is liable to 
become flattened in front and arched behind, in consequence of 
the difficulty of respiration, thus predisposing the patient to pul- 
monary disease. On looking into the throat the enlarged tonsils 
may be seen, as in the figure. Sometimes they are so greatly 
increased in size that they touch each other 420 
COMMON SENSE MEDICAL ADVISER. 
766. Treatment. The indications to be carried out in 
the cure of this malady are: 
(1.) To remedy the constitutional derangement. 
(2.) To remove the enlargement of the tonsil glands. 
767. The successful fulfillment of the first indication may be 
readily accomplished by attention to hygiene, diet, clothing, and 
the use of my Golden Medical Discovery, together with small 
daily doses of my Pleasant Purgative Pellets. This treatment 
should be persevered in for a considerable length of time after 
the enlargement has disappeared, to prevent a return. 
768. To fulfill the second indication, astringent gargles may 
be used. Infusions of witch-hazel (**| 518) or cranesbill 519) 
answer well, used during the day. The following is unsurpassed: 
Take of iodine one drachm, iodide of potash four drachms, pure 
soft water two ounces—mix. Apply this to the enlarged tonsils 
twice a day, with a probang or soft swab, being careful to paint 
them each time. Some considerable length of time, and a perse- 
vering use of the treatment, both internal and local, is necessary 
for their reduction and restoration to a healthy condition. 
769. Sometimes the enlarged tonsils take on calcareous 
(chalky) degeneration; in this case nothing but their removal 
by a surgical operation will be effectual. This can readily be 
accomplished by any competent surgeon. I have operated in a 
large number of cases, and have never met with any unfa- 
vorable results. 
ELONGATION OF THE UVULA. 
770. Chronic enlargement or elongation of the uvula (palate), 
as shown at “b,” Fig. 146, may arise from the same causes as 
enlargement of the tonsils. It subjects the individual to a great 
deal of annoyance by dropping into and irritating the throat. It 
causes tickling and frequent desire to clear the throat; change, 
weakness, or entire loss of voice; difficulty of breathing; fre- 
quently giving rise to the most persistent and aggravating cough. 
771. Treatment. The treatment already laid down for 
enlarged tonsils, with -which affection of the uvula is so often 
associated, is generally effectual. When it has existed for a long 
time and does not yield to this treatment, it may be removed by 
any competent surgeon. ANAEMIA. 
421 
ANiEMIA. 
772. When the blood is deprived of the ordinary amount of 
red corpuscles, it then is anaemic, characterized by every sign of 
debility. A copious hemorrhage in consequence of a cut, or 
other serious injury, will lessen the quantity of blood and pi’o- 
duce anaemia. After sudden blood-letting, the volume of the 
circulation is quickly restored by absorption of fluid, but the red 
corpuscles cannot be so readily replaced, so that the blood is 
poorer by being more watery. This is only one way in which 
the blood is impoverished. 
The blood may be exhausted by a drain upon its richness in 
consequence of hard and prolonged study. Severe mental em- 
ployment consumes the red corpuscles, leaving the blood languid, 
skin cool and pale, and the extremities moist and cold. 
773. Anaemia may arise from lack of exercise, or it may be 
occasioned by mental depression, anxiety, disappointment, 
trouble, acute excitement of the emotions or passions, spinal 
irritation, in fact, there are many special relations existing be- 
tween the red globules of the blood and the various states of the 
mind and the nervous system. The latter depends directly 
upon the health and quantity of these red globules for its ability 
to execute its functions. 
774. Anaemia may arise in consequence of low diet, or because 
the alimentary organs do not properly solve the food, or when 
there is not sufficient variety of edibles. Xo matter how anaemia 
is occasioned, whether by labor and expenditure, by hemorrhages, 
lead poisoning, deprivation of food, indigestion, mal-assimilation, 
frequent child-bearing, or lactation, the condition of the blood 
consists in a material diminution of its red globules. 
775. The diagnostic symptoms of anaemia are palor of the 
face, lips, tongue and general surface, weakness of the vital 
organs, hurried respiration on slight exercise, swelling or puffiness 
of the eyes, bellows-like murmur of the heart, etc. 
776. This disorder of the blood tends to develop low inflam- 
mation, dropsical elfusion, tubercles, Bright’s disease, cancers, 
derangements of the liver, pulmonary diseases, diarrhoea, leucorr- 
hoea, and is a precursor of low protracted fevers. It contributes 
largely to the activity of other affections, providing they are in 422 
COMMON SENSE MEDICAL ADVISER. 
existence, and often it is found associated with Bright’s disease, 
cancer, and lung difficulties. 
777. Treatment. First—Prevent all unnecessary waste 
and vital expenditure. 
Second—Place the patient under favorable circumstances for 
recovery, by regulating the exercise and clothing, entertaining 
the mind, and furnishing plenty of good air. 
Third—Prescribe such a nutritious diet as will agree with the 
enfeebled condition of the patient. 
Fourth—Regular habits must be established in regard to 
meals, exercise, recreation, rest and sleep. 
Fifth—The use of tonics and stimulants, as much as the 
stomach will bear, should be encouraged. Bathe the surface 
with a solution of a drachm of quinine in a pint of whisky. 
Sixth—Iron 618), in some form, is the special internal rem- 
edy in anaemia. Meantime, it is proper to treat the patient with 
gentle manual friction, rubbing the surface of the body lightly 
and briskly with the warm, dry hand, which greatly stimulates 
the circulation of the blood. Anaemia occurs more frequently 
with the female than with the male, because her functions and 
duties are more likely to give rise to it. 
APNCEA. 
778. Apnoea (a deficiency of breath), or short, hurried, diffi- 
cult respiration, is occasioned by certain conditions of the blood. 
The red globules are sometimes called oxygen carriers, and it is 
undoubtedly true that they do absorb and transport such gases 
as oxygen, nitrogen and carbonic acid. By the agency of the 
lungs, they receive and impart gases, 75). When this inter- 
change of aeriform elemeuts is not brought about, the blood is 
not changed from venous to arterial and is incapable of sustain- 
ing life. This morbid condition is termed asphyxia. We often 
read of persons going into wells where there are fixed gases, or 
remaining in a close room where there are live coals generating 
carbonic acid gas, and thus becoming asphyxiated—dying for 
want of oxygen. 
779. Deficiency of oxygen is the cause of apnoea,and sometimes 
the red globules themselves are so few, worn out and destroyed, 
that they cannot carry enough oxygen, and the consequence DKOPSIES. 
423 
is that the patient becomes short of breath and when a fatal 
degeneration of the globules ensues, he dies of asphyxia. Many 
a child grows thin and wan and continues to waste away, 
the parents little dreaming that the slow consumption of the 
red globules of the blood is the cause which is undermining the 
health. Sometimes this disease is the result of starvation, 
irregular feeding, improper diet, want of care, and at other 
times, want of fresh air, proper exercise and sunlight. 
780. Treatment. The first essential to success in the 
treatment of this disease, is the removal of the exciting cause. 
Exercise in the outdoor air and sunlight,with good nutritious food 
and well ventilated sleeping apartments, are of the greatest im- 
portance. The bitter tonics, as hydrastin (T 613), with pyro- 
phosphate of iron to enrich the blood and build up the strength, 
must not be omitted. 
LEUCOCYTILEMIA. 
781. This long word, once seen, always remembered, means 
white cell blood; that is, the disease consists in the multiplica- 
tion of white corpuscles, so that relatively they become more 
numerous than they ought to be. In health, these white cor- 
puscles, which are nearly twice the size of the red, should ex- 
ist only in the proportion of one, to one or two hundred, of the 
red corpuscles. These colorless corpuscles increase when there 
is disease of the lymphatic glands, and whether this is the cause 
of their increase or perversion is not known. 
782. They have been found abundant in the blood in diseases 
of the spleen and of the liver. Diarrhoea usually attends this 
complaint, together with difficult breathing, loss of strength, 
gradual decline, fever, exhaustion, diminution of vital forces, and 
finally death. The recovery of a well-marked case of this disease 
is very doubtful. Its average duration is about one year. 
DROPSIES. 
783. Transudation is the passage of fluid through the tissue 
of any organ, without changing its liquid state, while exudation 
means, medically, the passage of matter that coagulates and 
gives rise to solid deposits. When transudations are unhealthy, 
they may accumulate in serous cavities or in cellular structures, 
and constitute dropsy. Exudation is the result of inflammation, 424 
COMMON SENSE MEDICAL ADVISER. 
and the product effused coagulates and becomes the seat of a 
new growth of tissue. Exosmosis means going from within 
outward, and is a process constantly taking place in health; while 
transudation takes place because the blood is watery and the 
tissues are feeble and permeable, allowing the serum and watery 
elements of the vital fluid to pass into certain cavities, where 
they accumulate. 
784. The cause of dropsies may be low diet, insufficient exer- 
cise, indigestion, hemorrhages, wasting diseases, in fact, any thing 
that impoverishes the blood and increases the relative amount 
of serum. The tardy circulation of blood in the veins, or its 
obstruction in any way, is a condition highly favorable to the 
development of dropsy. 
785. General dropsy is called anasarca, and is readily distin- 
guished by bloating or puffiness of the skin. It is also called 
oedema. This soft swelling yields under the finger, is pale, with- 
out pain, and preserves the impression of the finger for some 
time. The oedema appears first in the lower extremities, next in 
the face, and from thence extends over the body. 
786. General dropsy is commonly due to a morbid and weak 
condition of the blood, and this may be the result of albuminuria, 
a disease of the kidneys, by which albumen is carried off in the 
urine: hence its name. As the character of this affection was 
not understood before the writings of Bright, it was named after 
him, and is called Bright’s Disease. This difficulty is frequently 
the sequel of scarlatina; that is, succeeds its termination, most 
generally the second or third week after the date of convales- 
cence. Hence, the utmost care should be taken of a patient 
recovering from scarlatina, that he does not heat himself or 
expose himself to cold, and the same caution is applicable during 
convalescence from measles, erysipelas and rheumatism. Drop- 
sies may be general, as in anasarca; or local, as dropsy of the 
heart, called Cardiac dropsy; dropsy of the peritoneum, the 
serous membrane which lines the abdominal cavity, and called 
Ascites\ dropsy of the chest, called Hydrothorax; dropsy of the 
head, called Hydrocephalus; dropsy of the scrotum, called 
Hydrocele. 
787. Dropsy is not therefore properly a disease, but the re- 
sult of previously existing conditions, which may be illustrated imorsiES. 
425 
thus: suppose the existence of disease of the valves of the heart, 
which obstruct the free flow of blood and thus retard its circula- 
tion; or suppose dilation of the heart which involves also weak- 
ness and diminished power to circulate the blood. In con- 
sequence the pulse grows small and weak, and the patient cannot 
exercise or labor as usual. By and by the lower limbs begin to 
swell, then the face and body; finally the skin looks dusky, the ap- 
petite is impaired, the kidneys become diseased, there is difficulty 
in breathing, and the patient, we say, dies of dropsy. Yet, dropsy 
was the result of a heart difficulty which retarded the circulation 
and enfeebled the system, and in this way the disease took its rise. 
788. Treatment. As has already been shown, dropsy 
is but a symptom of various morbid conditions existing in the 
system, and any treatment to be radically beneficial must there- 
fore have reference to the diseased conditions upon which the 
dropsical effusion, in each individual case, depends. These are so 
various and many times so obscure, as to require the best diag- 
nostic skill possessed by the experienced specialist, to detect 
them. There are, however, a few general principles that are 
applicable to the treatment of nearly all cases of dropsy. Nu- 
tritious diet, frequent alkaline baths to keep the skin in good 
condition and favor depuration through its pores, and a general 
hygienic regulation of the daily habits, are of the greatest im- 
portance. There are also a few general remedies that will prove 
more or less beneficial in nearly all cases. I refer to diuretics 
(*f 558) and hydragogue cathartics 533). The object sought in 
the administration of these is the evacuation of the accumulated 
fluids through the kidneys and bowels, thus giving relief. Of 
the diuretics, queen of the meadow, buchu and saltpetre will gen- 
erally operate well. As a cathartic, my Purgative Pellets accom- 
panied with a teaspoonful or two of cream of tartar, will prove 
serviceable. Beyond these general principles of treatment it 
would be useless for me to attempt to advise the invalid suffering 
from any one of the many forms of dropsy. The specialist, skilled 
by large experience in detecting the exact morbid condition 
which causes the watery effusion and accumulation, will select his 
remedies to meet the peculiar indications presented by each in- 
dividual case. Sometimes the removal of the watery accumula- 
tion by tapping becomes necessary, in order to afford relief and 426 
COMMON SENSE MEDICAL ADVISER. 
give time for remedies to act. I have found it necessary to per- 
form this operation very frequently in cases of hydrocele (dropsy 
of the scrotum), and also quite often in cases of abdominal 
dropsy. The chest has also been tapped and considerable quan- 
tities of fluids drawn off, and this has been followed by prompt 
improvement and final cure. 
CASES TREATED. 
789. Case I. Mr. J. S., a Canadian gentleman, aged 68, 
applied at the World’s Dispensary in May, 1874, for examination 
and treatment. lie had been dropsical for over two years, and 
had become so badly affected as to be unable to lie down at 
night. His legs were so filled with water and enlarged as to 
render it almost impossible for him to walk. There was a gen- 
eral dropsy of his whole system. The least exertion was attended 
by the greatest difficulty of breathing. He had been under 
the treatment of sevei’al eminent general practitioners of medi- 
cine in Canada but found no relief. They were unable to dis- 
cover the real cause of his ailment, but to the specialist who has 
charge of this class of diseases at the World’s Dispensary, and 
who annually examines and treats hundreds of such cases, it was 
at once apparent that the dropsy was caused from a weakened 
condition of the heart, disqualifying it for properly circulating 
the blood. He was put upon a tonic and alterative course of 
treatment, which also embraced the use of such medicines as 
have been found to exert a specific tonic action upon the muscu- 
lar tissues of the heart. He improved so rapidly that in less 
than two months he was able to lie down and sleep soundly all 
night. The bloating all disappeared, his strength improved, and 
in three months more he was discharged perfectly cured. 
790. Case II. Henry C. F., aged 42; consulted me by 
letter in February, 1872, stating that lie was troubled with gen- 
eral bloating which had made its appearance gradually and was 
attended by general debility and other symptoms that have been 
enumerated as common to general dropsy. He had been under 
the treatment of several home physicians without receiving any 
benefit; had steadily grown worse until he felt satisfied that if he 
did not soon get relief he could not live very long. He was re- 
requested to send a sample of his urine for examination, as I had DROPSIES. 
427 
suspicions, from the symptoms which he gave, that the cause of 
his dropsy was albuminuria, or Bright’s disease of the kidneys. 
On examination of the urine my conjectures were shown to have 
been well founded, for albumen in very perceptible quantities was 
found to be present in this excretion. I had, about this time, 
come into possession of a remedy said, by very good authority, 
to be a specific in degeneration of the kidneys when not too far 
advanced, and I determined to test it upon this well-marked case. 
I accordingly prescribed it, together with other proper tonics 
and alteratives, at the same time giving the patient important hy- 
gienic advice which must be complied with if success is attained 
in the management of this very fatal malady. My patient grad- 
ually improved and in a few month’s time was restored to perfect 
health, which he has continued to enjoy ever since. From my 
subsequent experience, embracing the treatment of quite a large 
number of cases of Bright’s disease of the kidneys, I am satisfied 
that it is, in its early stage, quite amenable to treatment. 
791. Case III. Erastus C. H., aged 35, single, applied 
at the World’s Dispensary in December, 1874, and consulted me 
for what he supposed to be enlargement of the testicles. The 
scrotum (page 218) was as large as his head, and it was with 
difficulty that he could conceal the deformity from general ob- 
servation. The disease was immediately recognized by the 
attending surgeon as dropsy of the scrotum. The liquid was 
promptly drawn off by tapping and a stimulating injection made 
into the scrotum to prevent re-accumulation. I mention this 
case'only because it is one among a very large number who 
have consulted me supposing that they were suffering from en- 
largement of the testicles, cancer or other morbid growth within 
the scrotum, when a slight examination has shown the difficulty 
to be hydrocele, a disease that is speedily and certainly cured by 
tapping, with a little after treatment. The operation is perfectly 
safe and almost entirely painless. 
792. Case IV. Miss J. C., aged 24, consulted me by 
letter in November, 1873, enumerating a long list of symp- 
toms which clearly indicated abdominal dropsy, resulting from 
suppression of the menses. A well regulated hygienic treatment 
was advised, and medicines calculated to restore the menstrual 
function by gradually toning up and regulating the whole system, 428 
COMMON SENSE MEDICAL ADVISER. 
were forwarded to her by express. Four month’s treatment re- 
sulted in her perfect recovery. Cases like this latter are very com- 
mon and generally yield quite readily to proper management. 
No harsh or forcing treatment for restoring the menstrual func- 
tion should be employed, as it will not only fail in accomplishing 
the object sought, but is almost sure to seriously and many 
times irreparably injure the system. The most difficult cases 
that I have had to deal with, have been those which had been 
subjected by other physicians to the administration of strong 
emmenagogues 574) in the vain effort to bring on the menses. 
RHEUMATISM. 
793. Prominent among constitutional diseases is the one 
known as rheumatism. It is characterized by certain local 
symptoms or manifestations in fibrous tissues. This term has 
been applied to neuralgic affections and to gout, but it differs 
from each in several essential particulars. Rheumatism may be 
divided into (1) Acute, (2) Chronic, (3) Muscular. 
794. Acute Articular Rheumatism. Acute or 
inflammatory rheumatism implies an affection of the articulations 
or joints. It usually commences with a sudden attack; some- 
times pain or soreness in the joints precedes the disclosure of the 
disease. The symptoms are, pain in the joints, tenderness, 
increased heat, swelling and redness of the skin. The pain varies 
in its intensity in different cases, and is especially excited by the 
movement of the affected parts. Swelling of the joints occurs, 
especially those of the knee, ankle, wrist, elbow, and the smaller 
joints of the hands and feet. The swelling and redness are gen- 
erally in proportion to the acuteness of the attack. Acute 
articular rheumatism is always accompanied with more or less 
fever. Sweating is generally a prominent symptom, and usually 
occurs during the night. The appetite is impaired, the tongue is 
coated, the bowels constipated, or there is diarrhoea. 
795. Tlie Duration of this Disease. Unlike 
fevers, its course is marked by fluctuations; frequently after a 
few days the pain subsides, tlie fever disappears, and convales- 
cence is apparently established, when suddenly, all the symptoms 
are renewed with even greater intensity than before. This dis- 
ease rarely proves fatal, unless it is translated to the heart. RHEUMATISM. 
429 
796. Causes. Rheumatism is frequently supposed to be 
occasioned by a suppression of the functions of the skin, and is 
generally attributed to the action of cold upon the surface of the 
body. But it is probable that this acts only as an exciting cause, 
and that it is wholly a disease of the blood. This form of rheu- 
matism usually occurs between the ages of fifteen and thirty, 
and prevails most extensively in changeable climates. Acute 
articular rheumatism seldom terminates in the chronic form. 
797. Chronic Articular Rheumatism. Articu- 
lar rheumatism, in the subacute or chronic form, is frequently 
observed in medical practice. The symptoms are pain and more 
or less swelling of the joints, although not of as grave a character 
as in acute rheumatism. There is frequently an absence of in- 
creased heat and redness. As in the acute form, so in this, the 
different joints are liable to be affected successively and irregu- 
larly, until after a time the disease becomes fixed in a single 
joint, and the fibrous tissues entering into the ligaments, tendons, 
etc., are liable to be affected. The appetite, digestion and nutri- 
tion, are often good, and in mild cases patients are able to pursue 
their daily vocations. The disease is supposed to be the same as 
in the acute form, only it is milder and, strange to say, more 
persistent. A diseased condition of the blood is supposed to be 
involved in both instances, but this morbid state is less extended 
and at the same time more obstinate in the chronic, than in the 
acute form. Subacute articular rheumatism is not always chronic, 
and may disappear in a shorter time than the acute form. Chronic 
articular rheumatism is not generally fatal, but danger lies in the 
liability to permanent deformities. 
798. Mwseniar Rheumatism. This affection is 
closely allied to neuralgia, and may properly be called myalgia. 
It exists under two forms, viz: acute and chronic. In acute 
muscular rheumatism, there is at first a dull pain in the muscles, 
which gradually increases. When the affected muscles are not 
used the pain is slight, and certain positions may be assumed 
without inducing it constantly; but in movements which involve 
contraction of the muscles the pain is very violent. In some 
cases the disease is movable, changing from one muscle to 
another, but usually it remains fixed in the muscle first attacked. 
The appetite and digestion are not often impaired and there is 430 
COMMON SENSE MEDICAL ADVISEE. 
no fever. The duration of this form of rheumatism varies from 
a few hours to a week or more. 
'799. In subacute or chronic muscular rheumatism, pain is 
excited only when the affected muscles are contracted with 
unusual force, and then it is similar to that experienced in the 
acute form. The chronic form is more apt to change its position 
than the acute. The duration of this form is indefinite. In both 
the acute and chronic forms some particular parts of the body 
are more subject to the affection than others. 
800. The muscles on the posterior part of the neck are sub- 
ject to rheumatic affection. It is termed torticollis or cervical 
rheumatism in such cases, and should be distinguished from 
ordinary neuralgia. When the muscles of the loins are affected 
it is commonly known as lumbago. In case the thoracic muscles 
are affected it is known as pleurodynia. In coughing, sneezing, 
and the like, the pain produced is not unlike that in pleuritis 
and intercostal neuralgia. 
One of the most marked features of muscular rheumatism, is 
the cramp-like pain, induced by the movements of the affected 
muscles, whereas the pain is slight when those muscles are 
uncontracted. This feature is very serviceable in distinguishing 
muscular rheumatism or myalgia from neuralgic affections. 
Another trait which distinguishes muscular rheumatism from 
neuralgia is that the former is characterized by great soreness, 
while the latter is not. There is also a distinction between in- 
flammation of the muscles and muscular rheumatism. In case of 
the former, there is continued pain, swelling of the parts, occa- 
sional redness and the presence of more or less fever, which 
conditions do not exist in the latter. Persons subject to rheuma- 
tism of the muscles, are apt to suffer from an attack, after ex- 
posure of the body to a draught of air during sleep, or when in 
a state of perspiration. 
801. Treatment of Acute Rheumatism. Ad- 
minister the spirit vapor bath 630) to produce free perspira- 
tion, which should be maintained by full doses of my Compound 
Extract of Smart-Weed. The anodyne properties of the latter 
will also prove very valuable in allaying the pain. Tincture or 
fluid extract of aconite root 596) may also be employed to 
assist in equalizing the circulation, and also to secure its anodyne RHEUMATISM. 
431 
action. Black cohosh 578) appears to exert a somewhat 
specific and salutary influence in this disease, and the tincture or 
fluid extract of the root of this plant may advantageously be 
combined with the aconite. Take fluid extract of aconite-root 
thirty drops; fluid extract black cohosh one drachm, water fifteen 
teaspoonfuls; mix. Dose, one teaspoonful every hour. The 
whole person should be frequently bathed with warm water, 
rendered alkaline by the addition of salseratus or soda. The 
painful joints may be packed in wool or in cloths wrung from 
the hot salseratus water, and the patient kept warm and quiet in 
bed. The acetate of potash 569) taken in doses of five 
grains, well diluted with water, every three or four hours, is very 
valuable in acute rheumatism. Its alkaline qualities tend to 
neutralize the acid condition of the fluids of the system, which 
is a feature of this disease, and it also possesses diuretic 
properties which act upon the kidneys, removing the offending 
blood poison from the system through these emunctories. If 
the joints are very painful, cloths wet in my Compound Extract 
of Smart-Weed and applied to them, and covered with hot 
fomentations, will very generally relieve the suffering. The 
majority of cases will yield quite promptly to the course of 
treatment already advised, if it be persevered in. The disease, 
however, sometimes proves obstinate and resists for many days 
the best treatment yet known to the medical profession. 
802. Treatment of Chronic Rheumatism. 
The general alkaline baths recommended in the acute affection 
are also valuable in the chronic. The spirit vapor-bath, the 
Turkish or Russian, as also the sulphur vapor-bath (see chapter 
on “ Water as a Remedial Agent ”) are all worthy of trial in this 
obstinate and painful disease. Alteratives are a very valuable 
class of agents in chronic rheumatism. A course of treatment 
that has proved very successful in this disease is as follows, 
viz: take acetate of potash, one ounce; fluid extract of black 
cohosh, one ounce; fluid extract of poison hemlock 482), two 
drachms; simple syrup, six ounces; mix. Dose, of this com- 
pound, one teaspoonful three times a day. My Golden Medical 
Discovery is also to be taken three times a day, in doses of 
two teaspoonfuls, alternately with the preceding compound. 
This thorough alterative course, if well persevered in, not 432 
COMMON SENSE MEDICAL ADVISER. 
neglecting the alkaline and vapor-baths, will generally prove 
very successful. The specialist, however, dealing with chronic 
diseases exclusively, will occasionally meet with a case that has 
been the rounds of the home physicians without benefit, which 
will tax his skill and require the exercise of all his perceptive 
faculties in determining the exact condition of the patient’s sys- 
tem, upon which the perpetuity of the disease depends. When 
this is ascertained the remedies will naturally suggest themselves 
and the malady generally promptly yield to them. But, although 
the treatment of this disease has entered largely into our prac- 
tice at the World’s Dispensary, and has been attended by the 
most happy results, yet the cases have presented so great a 
diversity of abnormal features and have required so many varia- 
tions in the course of treatment to meet them successfully, that 
I frankly acknowledge my inability to so instruct the non-pro- 
fessional reader, as to enable him to detect the various systemic 
faults common to this ever-varying disease, and adjust remedies 
to them, so as to make the treatment uniformly successful. If 
the several plans of treatment which I have given do not con- 
quer the disease, I cannot better advise the invalid than to 
recommend him to employ a physician of well established skill 
in the treatment of chronic disorders. If such an one is not 
accessible for personal consultation, a careful statement of all 
the prominent symptoms, in Avriting, may be forwarded to a 
specialist of large experience in this disease, who will readily 
detect the real fault, in which the ailment has its foundation. 
Particularly easy will it be for him to do so, if he be an expert 
in the analysis of urine. A vial of this should be sent with the 
history of the case, as chronic rheumatism effects characteristic 
changes in this excretion, that clearly and unmistakably indicate 
the abnormal condition of the fluids of the body, upon which the 
disease depends. 
GOUT. 
803. Gout is closely allied to rheumatism, and the two, by 
some authors, have been regarded as identical. They, however, 
show distinct points of contrast, and each affection should have 
a separate individuality in the catalogue of diseases. Rheuma- 
tism usually affects the larger joints, while gout attacks the GOUT, 
433 
smaller ones, for example, the toes. The cause of this disease is 
an immoderate use of stimulating food and drinks. Plethoric 
people are its most common victims. 
The distinguishing characteristic of gout is a morbid deposit 
within and around the joints. When recent, the deposit is a 
seini-solid, cream-colored substance, resembling mortar. By the 
aid of the microscope, needle-shaped crystals are seen to have 
formed around the joint. At length these become hardened into 
masses, have a chalk-like appearance, and are supposed to be 
salts of soda, which are deposited here instead of being expelled 
from the system through the kidneys, as nature designed. These 
deposits occur in gout, are peculiar to it, and to no other dis- 
ease. Gout may appear in three forms, viz: Acute, Chronic, and 
Retrocedent. 
Acute Gout. This form of the disease is usually sudden, 
occurring in the night, and is of short duration. The attack is 
marked by pain, which is generally in one of the great toes. 
Often the disease is extended from the toe to the heel, ankle, and 
larger joints. Its duration varies from a few days to several 
weeks. 
Chronic Gout. In this form, the pain, heat, and redness, 
which characterize the acute form of the affection, are very 
slight or entirely wanting. The “ chalky concretions ” arc de- 
posited about the joints, and sometimes make their way through 
the skin. In some cases, patients become crippled and deformed. 
Retrocedent Gout. This is a form in which the affection is 
transferred from the external parts to some internal organ, as 
the stomach, intestines, lungs, or brain. It is sometimes, though 
seldom, transferred to the heart. 
804. Treatment. The purpose of the treatment is to 
rid the blood of uric acid; to render this acid more soluble, 
alkaline remedies are given. The bicarbonate of potash is one 
of the best; or ten grains of phosphate of ammonia; or the 
urate of lithia may be given in five grain doses three times per 
day. In other respects, the treatment of this affection is similar 
to that suggested for rheumatism. Colchicum has been largely 
employed as a remedy for gout and is frequently followed by 
good results. It excites the kidneys to action and thus removes 
the blood poison from the system through these excretory 434 
COMMON SENSE MEDICAL ADVISER. 
organs. The wine of colchicum may be taken in one-half 
teaspoonful doses three times a day. 
805. It is estimated that about one-fifth of the human family 
are afflicted with scrofula. A disease so prevalent and so destruc- 
tive of life, should enlist universal attention and the best efforts 
of medical men, in devising the most successful treatment for its 
cure. It varies in the intensity of its manifestation, from the 
slightest eruption upon the skin (scrofulous eczema), to that most 
fatal of maladies—pulmonary consumption. 
SCROFULA. 
806. The Scrofulous Diathesis. The existence of 
a certain disposition or habit of body, designated as the scrofu- 
lous or strumous diathesis, cachexia or dyscrasia, is generally 
recognized by medical practitioners and writers as a constitu- 
tional condition predisposing many children to the development 
of this disease. Enlargement of the head and abdomen, fair, 
soft and' transparent, or dark, sallow, greasy or waxy-looking 
skin and precocious intellect, are supposed to mark this diathesis. 
807. The characteristic feature of this disease, in all the mul- 
tifarious forms which it assumes, is the formation of tubercle, 
which, when the malady is fully developed, is an ever-present 
and distinguishing element. 
Tuberculous is therefore almost synonymous with scrofulous, 
and to facilitate an understanding of a large list of very preva- 
lent maladies, we may, generalize and classify them all under 
this generic term. As tubercle will frequently be spoken of, 
playing as it does, a conspicuous part in an important list of dis- 
eases which will hereafter be considered, the reader will naturally 
be led to inquire, 
808. What is Tubercle ? As employed in pathology 
the term is applied to “ a species of degeneration, or morbid 
development of an opaque matter of a pale yellow color, having, 
in its crude condition, a consistence analogous to that of concrete 
albumen.” The physical properties of tubercle are not uniform, 
however. They vary with age and other circumstances. Some 
are hard, chalky and calcareous, while others are soft and pus- 
like. The color also varies from a light yellow, or almost white, 
to a dark gray. SCROFULA. 
Its chemical constituency is almost wholly albumen united with 
a small amount of earthy salts, as phosphate and carbonate of 
lime, with a trace of the soluble salts of soda. 
The existence of tubercular deposits in the tissues of the body 
which characterizes scrofula, when fully developed, must not, 
however, be regarded as the primary affection. Its formation is 
the result of disordered nutrition. The products of digestion 
are not fully elaborated and pass into the blood imperfected, 
in which condition they are unable to fulfill their normal destiny 
—the repair of the bodily tissues. Imperfectly formed albumin- 
ous matter oozes out from the blood and infiltrates the tissues, 
but it has little tendency to take on cell-forms, or undergo the 
vital transformation essential to becoming a part of the tissues. 
Instead of nutritive energy, which by assimilation, produces 
perfect bodily textures, this function, in the scrofulous diathesis, 
is deranged by debility, and there is left in the tissues an imper- 
fectly oi’ganized particle, incapable of undergoing a complete 
vital change, around which cluster other particles of tubercular 
matter, forming little grains, like millet seed, or growing, by 
new accretions of like particles, to masses of more extensive 
size. As tubercle is but a semi-organized substance, of deficient 
vitality, it is very prone to disintegration and suppuration. 
Being foreign to the tissues in which it is embedded, like a thorn 
in the flesh, it excites a passive form of inflammation and from 
lack of inherent vital energy it is apt to decompose and dissolve 
into pus. Hence, infiltration of the muscles, glands or other 
soft parts with tuberculous matter, when inflammation is aroused 
by its presence, or by its presence combined with an exciting 
cause, gives rise to abscesses, as in lumbar or psoas abscess, when 
occurring in the psoas muscle of the back. When occurring in 
the joints, tubercles give rise to chx-onic suppurative inflamma- 
tion, as in white swellings, hip-joint disease, etc. Various skin 
diseases are regarded as local expressions of, or as being ma- 
terially modified by, the scrofulous diathesis, as eczema, impetigo 
and lupus. The disease popularly known as “ fever-sore ” is 
another form of scrofulous manifestation, affecting the shafts of 
the bones, and causing disorganization and decay of their struc- 
ture. Discharges from the ear, bronchitis, chronic inflammation 
of the intestinal mucous membrane, and chronic diarrhoea are 436 
COMMON SENSE MEDICAL ADVISER. 
frequently due to scrofula, while pulmonary consumption is 
unanimously regarded as a purely scrofulous affection. Scrofula 
shows a strong disposition to manifest itself in the lymphatic 
glands, particularly the superficial ones of the neck. The most 
distinguishing features of this form of the disease is the appear- 
ance of little kernels or tumors about the neck. These often 
remain about the same size, neither increasing nor diminishing, 
until finally, without having caused much inconvenience, they 
disappear. After a time these glands may again enlarge, with 
more or less pain accompanying the process. As the disease 
progresses, the pain increases, and the parts become hot and 
swollen. At length the matter which has been forming beneath 
finds its way to the surface and is discharged in the form of thin 
pus, frequently characterized by containing little particles or 
flakes of tubercular matter. During the inflammatory process 
there may be more or less febrile movement, paleness of the sur- 
face, languor, impaired appetite, night sweats and general 
feebleness of the system. The resulting open ulcers show little 
disposition to heal. 
809. Symptoms. There is a train of symptoms char- 
acteristic of all scrofulous diseases. The appetite may be 
altogether lost or feeble, or, in extreme cases, voracious. In 
some instances, there is an unusual disposition to eat fatty sub- 
stances. The general derangement of the alimentary functions 
is indicated by a red, glazed or furrowed appearance of the 
tongue, flatulent condition of the stomach and bloated state of 
the bowels, followed by diarrhoea or manifesting obstinate con- 
stipation. Thirst and frequent acid eructations accompany the 
imperfect digestion. The foul breath, early decay of the teeth, 
the slimy glairy stools, having the appearance of the white of 
eggs, and an intolerable fetor, all are indicative of the scrofulous 
tendencies of the system. 
810. Causes. Scrofula may be attributed to various 
causes. Observation is convincing that ill-assorted marriages, 
from temperamental inadaptations, is a prolific source of scrofula. 
Both parents may be not only healthy, and free from all heredit- 
ary taints, but robust,well-formed physically, perfectly developed, 
and yet not one of their children be free from this dire disease. 
It may present itself in the form of hip-disease, white swelling, SCROFULA. 
“ fever-sore,” suppurating glands, curvatures of the spine, rickets, 
ulcers, pulmonary consumption, or some skin disorder, in either 
case showing the original perversion of the constitution and 
functions see 236). These consequences following the mar- 
riage of such healthy parties cannot be reasonably accounted 
for upon any other hypothesis, and yet there is no standard 
writer of acknowledged excellence on medical subjects, who has 
more than merely hinted that there is any such thing as tempera- 
mental incompatibility, producing these results. Scrofula is 
hereditary when the disease, or the diathesis which predisposes 
to its devolopmen.t, is transmitted from one or both parents who 
are affected by it, or who are deficient in constitutional energy, 
showing feeble nutrition, lack of circulatory force, and a dimin- 
ished vitality. All these conditions indicate that a few expos- 
ures, and contractions of severe colds, are sufficient to set in 
motion a train of symptoms, which are completed in pulmonary 
or other strumous affections. Whatever deranges the function 
of nutrition, is favorable to the development of scrofula; there- 
fore, irregularities and various excesses tend to inaugurate it. 
Depletion of the blood by drastic and poisonous medicines, as 
antimony, arsenic and mercurials, hemorrhages and blood-letting, 
the inoculation of syphilis, excessive mental or physical labor, as 
well as a too early use and abuse of the sexual organs, all tend 
to waste the blood, reduce the tone of the system, and develop 
scrofula. 
811. Scrofula may be the consequence of insufficient nourish- 
ment, resulting from subsisting upon poor food, or a too exclu- 
sively vegetable diet, with little or no animal food. 
Want of exercise and uncleanliness contribute to its produc- 
tion. It is much more prevalent in temperate latitudes, where 
the climate is variable, than in tropical or frigid regions. The 
season of the year also greatly influences this disease, for it many 
times commences in the winter and spring, and disappears again 
in the summer and autumn months. 
812. Treatment. The skin should be kept clean by 
means of frequent baths. These assist the functional changes 
which must take place on the surface of the body, permit the 
stimulating influence of the light and air, and facilitate the aera- 
tion of the blood as well as the transpiration of fluids through the 438 
COMMON SENSE MEDICAL ADVISER. 
innumerable pores of the skin. All exposures to a low tempera- 
ture, especially in damp weather, and the wearing of an insufficient 
amount of clothing, should be avoided. Then the food should 
be generous and of the most nourishing and digestible character. 
Steady habits, and regular hours for eating and sleep must be 
observed, if we would restore tone and regularity to the func- 
tions of nutrition. Moderate exercise in the open air is essential, 
in order that the blood may become well oxygenized, that the 
vital changes may take place, and healthy stimuli be applied to 
the solids. It is no doubt true that the occasion of the preva- 
lence of scrofula among the lower classes may be ascribed to 
frequent and severe climatic exposures, irregular and poor diet, 
or want of due cleanliness. Every well-regulated family can 
avoid such causes, and live with a due regard to the conditions 
of health. The proper treatment of scrofula is important, be- 
cause we meet with its symptoms on every side, showing its 
slow action upon different parts of the body and its influence 
upon all the organs. After this disease has been existing for an 
indefinite length of time, certain glands enlarge, slowly inflame, 
finally suppurate, and are very difficult to heal. These sores are 
very liable to degenerate into ulcers. All of these symptoms 
point to a peculiar state of the blood, which continually feeds 
and strengthens this morbid outbreak. Hence all authors agree 
that the blood is not rich in fibrinous elements, but tends to 
feebleness and slow inflammation, which ends in maturation. 
Thus we trace back this low and morbid condition of the blood 
to debility of the nutritive organs, defective digestion, which 
may be induced by irregular habits, a lack of nourishing food, or 
by the acquiring of some venereal taint, which poisons the deli- 
cate operations of vitality and breeds its own slow process of 
decay and suppuration. 
813. The matter that is discharged from these glands is not 
healthy, but is thin, serous and acid; a whey-like fluid contain- 
ing little fragments of tuberculous matter, which resembles curd. 
The affected glands ulcerate, look blue and indolent, and mani- 
fest no disposition to heal. I have thus traced this disorder 
back to weak, perverted and faulty nutrition, to disordered and 
vitiated blood, the products of which slowly and chronically in- 
flame the glands, which strain out unhealthy, irritating, poisonous SCROFULA. 
439 
matter. The medicines to remedy this perverted condition of 
the blood and fluids must be alteratives, that will act upon the 
digestive organs and tone the nutritive f unctions, thus enriching 
and purifying the blood. As this disease holds special relations 
to a large majority of chronic diseases, it is eminently proper 
that I refer to a feAV considerations involved in its general 
treatment. 
814. An alterative medicine belongs to a class \\Thich is 
considered capable of producing a salutary change in a disease, 
without exciting any sensible evacuation. In scrofula these rem- 
edial changes are required in digestion, chymification, and also 
to prevent certain morbid, decomposing operations in the blood, 
thus reconstructing it, so that it may produce sound tissues. 
815. It is well known to medical men that nearly all medi- 
cines belonging to the class of alteratives, are capable of solution 
in the gastric and intestinal secretions, and pass without material 
change, by a process of absorption, through the coats of the 
stomach and intestines, as do liquids, and so gain an entrance 
into the general circulation ; that these same alteratives act 
locally to tone and energize the mucous surfaces, and thus pro- 
mote and rectify the process of digestion before being absorbed; 
that alterative medicines, when in the blood, must permeate the 
mass of the circulation, and thus reach the remote parts of the 
body and influence every function; that these medicines, while 
in the blood, may combine with it, reconstruct it, and arrest its 
morbid tendencies to decomposition. 
816. On putting these facts together we are driven to certain 
conclusions Avith respect to remedies for the treatment of scrof- 
ida. We must use those alteratives which Avill 1st, give tone 
to the digestive and nutritive functions, in order to curtail the 
constant propagation of scrofula in the system; 2d, alter and 
purify the blood through the natural and insensible functions, 
thus reconstructing it; and 3d, check the septic, disorganizing 
changes which are evinced by the irritating and poisonous matter 
discharged from the ulcers. 
817. These three ways are distinctly recognized by the pro- 
fession as modes in which medicines operate upon the nutritive 
functions and the blood. 
818. Thus we see that alteratives may he specifics, in so far 440 
COMMON SENSE MEDICAL ADVISER. 
as they are particularly useful in certain disorders, and the com- 
bination which I have made in perfecting the Golden Medical 
Discovery, excels all others with which I am acquainted, for 
scrofulous diseases, particularly in fulfilling the foregoing indi- 
cations. It works out peculiar processes in the blood, not like 
food, by supplying merely a natural want, but by strengthening 
the nutritive functions and counteracting morbid action, after 
which operations it passes out of the system by excretion. 
819. From what has been said upon the importance of blood 
medicines and their modes of action, the reader must not infer 
that I account for all diseases by some fault of the humors of the 
body, for I do not. But that scrofula, in its Protean forms, 
results from mal-nutrition and disorders of the blood, is now 
universally conceded. It is for this reason that I have spared 
neither time nor pains in perfecting an alterative, tonic, nutritive, 
restorative and antiseptic compound, to which I have given the 
name of Alterative Extract or Golden Medical Discovery. Not 
only is it an alterative and a nutritive restorative, acting upon the 
secretions and excretions, but it opposes putrefaction and degener- 
ative decay of the fluids and solids. Hence its universal indication 
in all scrofulous diseases. 
820. It will intercept those thin, watery discharges, which are 
consequent upon weakness, degeneration and putrescent decay 
of the blood, perpetuated by a low grade of scrofulous inflam- 
mation. For an adult it can be taken in doses of from one to 
two teaspoonfuls three or four times per day. 
821. Attention should he paid to the bowels, that they be 
kept in order. If costive, one or two Purgative Pellets, taken 
daily, will fulfill this indication. A tea made from the barks of 
tag alder, sassafras and prickly-ash, equal parts combined, is a 
common domestic remedy and called good to purify the blood. 
While it will do no harm, it will not be found very efficient. A 
tincture made by putting fresh common burdock and yellow 
dock roots into whisky, and taking a tablespoonful once a day 
in the morning shortly after rising, may sometimes be beneficial, 
yet it cannot always be relied upon. The patient must not neg- 
lect to carry out all the hygienic recommendations heretofore 
given. The treatment of local tumors or running sores is very 
'simple. Cleanse them every day with Castile-soap and water, LUMBAR ABSCESS. 
441 
and apply some mild ointment, as one made by adding together 
one part each, by weight, of bees-wax and mutton tallow, and 
two parts of lard. 
LUMBAR ABSCESS. (Psoas Abscess.) 
822. Lumbar abscess is a form of scrofula, generally com- 
mencing in the small of the back near the origin of the psoas 
muscles. It then runs down over the pelvis and generally 
locates in the groin, near the place where the thigh-bone articu- 
lates with the hip-bone. 
823. The Symptoms of lumbar abscess are dull, heavy 
pains, extending down the outside of the thigh—sometimes to 
the foot. When the patient is in a reclining position, he is apt 
to flex the thighs upon the abdomen. The pain finally becomes 
more intense, the appetite impaired, the breath foul, and general 
chilliness is experienced, together with night sweats and other 
accompaniments of fever. 
824. The swelling is caused by a collection of matter in the 
cellular tissue. The cyst or bag which contains the matter is 
continually enlarging as the matter increases. When the abscess 
is opened or bursts by ulceration, the surface of the cyst becomes 
inflamed. The discharge consists of flaky tuberculous matter, 
mingled with pus. 
825. Treatment. The principles to be observed in the 
treatment of this affection are (1), to preserve the strength of 
the patient by the plentiful use of very nutritious articles of 
diet (2), to tone the digestive functions and (3), to constantly 
employ the best alteratives. All the hygienic recommenda- 
tions which have been suggested under the treatment of 
scrofula, apply to the management of this peculiar mode of its 
manifestation. No depletive or exhausting treatment is allowa- 
ble, but the free use of tonic and antiseptic alteratives must be 
persistently followed. The patient should have plenty of fresh 
air, sunlight, cheerful company, invigorating stimulus, and a 
nourishing diet such as beef, eggs, etc. 
826. If these abscesses are opened, it must be done so as not 
to permit the entrance of air to the suppurating surface, for that 
will only intensify the inflammation. And when injections are 
made with a view to change the character of the morbid action 442 
COMMON SENSE MEDICAL ADVISER. 
already set up, they should be introduced so as not to permit the 
entrance of air. These surgical means should not be undertaken 
without weighing all the liabilities and consequences, for they 
are often rashly employed by inexperienced surgeons. Such 
measures should be well considered before they are adopted. 
827. Coxalgia, also known as Hip Disease, is a scrofulous 
affection of the hip-joint. It usually attacks children, but may 
occur at any period of life. The causes of this affection are im- 
perfectly understood, yet all the indications point to a scrofulous 
state of the system. Dampness, coldness, improper diet, severe 
injuries from blows, falls, etc., are all numbered among the 
exciting causes which are conducive to the establishment of this 
disease. 
HIP-JOINT DISEASE. (Cqxalgia.) 
828. The Symptoms are developed gradually; at first 
there is severe pain in the knee, but finally it is experienced in 
the hip-joint. Occasionally it is noticed in the hip and knee at 
the same time. As the disease progresses, the general health 
becomes impaired, there is wasting of the muscles, wakefulness, 
disturbed sleep, high fever, profuse and offensive perspiration, 
the hair falls out and there is an inability to move the limb with- 
out producing excruciating pain. Frequently pus will be formed 
and discharged at different points, and the limb will become 
greatly emaciated. Since pain in the knee-joint may mislead 
as to the location of the disease, to determine, place the 
patient in a chair and percuss the knee lightly, by giving it a 
slight blow with the knuckle; if the hip be affected, the pain 
will readily be felt in that joint; if it be simply neuralgia of the 
knee-joint, it will excite no pain whatever. After the disease 
progresses and luxation of the joint takes place, the limbs will 
be of unequal length. 
829. Treatment. The indications for the remedial mair- 
agement of this disease consist in (1), absolute rest for the hip- 
joint; (2), cleanliness of the person and plenty of fresh air and 
light; (3), keeping the body at an even and comfortable temper- 
ature; (4), plenty of beef, eggs, soup and fresh vegetables; and 
(5), to encourage the appetite, the use of tonics and sustaining al- 
terative medicines, without which we may not expect a favorable WHITE SWELLING. 
issue or recovery from the disease. This class of medicines 
must be continually and persistently employed in order to 
obtain their best results. It is a slow inflammation which is not 
easily turned from its course, and its fatality should be a warn- 
ing to employ the best alteratives with a view to overcome and 
remedy the scrofulous condition of the system. The skin should 
be toned by the use of a salt, or salt and mustard bath daily, 
bathing the spine at night with a wash made as follows: Alcohol, 
one pint; quinine, one drachm; powdered red, or cayenne pep- 
per, one tablespoonful; mix, and pour a tablespoonful in the 
hollow of the hand and apply it between the shoulders, slowly 
and gently rubbing the surface until the skin becomes dry. In 
the same manner apply the wash to the middle and lastly to 
the lower region, of the back. These indications and measures 
must be patiently and faithfully followed, to secure the full benefit 
which they promise. An unsteady, vacillating course of treat- 
ment will most assuredly be unsuccessful. 
WHITE SWELLING. 
830. White Swelling, otherwise known as Hydrarthrus or 
Synovitis, more frequently affects the knee-joint than any other 
part. The elbow, wrist, ankle, or toe-joints may, however, be 
affected with this disease, but we shall speak of it in this connec- 
tion as affecting only the knee-joint. Synovitis may be acute 
or chronic. This last form is sometimes induced by blows, 
sprains, falls, etc., or from exposure to cold; more frequently it 
is the result of rheumatism or scrofula. 
831. The Symptoms of this affection are generally 
slow in their appearance, being sometimes months in manifesting 
themselves. The joint at first presents only a slight degree of 
swelling, which gradually increases. Pain is soon felt, mild at 
first, but augmenting until it becomes severe. The skin has a 
smooth, glistening appearance, and there is an increased amount 
of heat in the parts. The affected limb becomes wasted and 
sometimes permanently flexed. There is more or less fever 
about the body, impairment of the digestive organs, and 
sleeplessness. The pulse is low but quick, night sweats and 
diarrhoea are often apparent. Under this irritation the patient 
is liable to waste away and finally die. 444 
COMMON SENSE MEDICAL ADVISER. 
A post-mortem investigation reveals the effects of the disease 
upon the parts attacked. The cartilages of the joint are soft, 
the synovial membrane is thickened, the ligaments are inflamed 
and often destroyed, the synovial fluid is increased in amount, 
sometimes normal in its appearance, again thick and viscous. If 
the bones be diseased, their articular extremities may be dis- 
tended and fatty matter deposited in them. The conditions 
depend upon the form, severity and duration of the disease. 
Synovitis may be considered under three heads, viz: llheu- 
matic, Strumous, and Syphilitic. 
llheumatic Synovitis may arise from exposure to cold, from 
some injury, or from an intemperate diet. The beginning 
of the disease may be distinctly marked, or it may be brought 
on so gradually that the time of its commencement cannot be 
noted. The pain is of a dull, steady character, and less severe 
in the night. This form of the disease sometimes terminates 
favorably, but in scrofulous systems it is liable to end in the 
destruction of the joint. It is more common in early life, 
rarely occurring after the thirtieth year. 
Strumous Synovitis, or tuberculosis of the knee-joint, when of 
a chronic character, shows a wasting of the limb, and the swelling 
is of a pulpy consistence. This form of the disease is more liable 
to occur in children, though occasionally it is met with in adults. 
But little pain accompanies this form, yet the limb is liable to 
become permanently affected. In the earlier stages this disease 
may be checked. 
Syphilitic Synovitis is incident to syphilis. The pain is more 
severe during the night. It, however, generally terminates unfa- 
vorably, especially in scrofulous constitutions. 
832. Treatment of white swelling should be both con- 
stitutional and local. Alterative medicines are indicated to 
correct the blood, and the following preparation will be found 
very useful. Blue flag-root, prince’s-pine, tag alder, burdock 
and yellow dock-root, each one ounce; best whisky, one quart; 
cold water, one quart; white sugar, one pound. The dose is one 
tablespoonful twenty minutes before meals. Or, what is superior, 
use the Golden Medical Discovery. 
Local treatment in the active stage of the disease is to steam 
the knee-joint and apply hot fomentations. Then follow this, by WHITE SWELLING. 
445 
using solid extract of stramonium or belladonna mixed with 
glycerine and applied over the joint, which should be wrapped 
in cotton or wool to keep it uniformly warm. If there be open- 
ings about the joint, discharging pus, syringe them out once a 
day with Castile soap-suds, and if a little bi-carbonate of potash 
(common salseratus) be added, it will be improved. See to it 
that the skin be kept active, that the bowels are regular, that the 
kidneys excrete freely, and that the diet be nourishing. Tonic 
medicines are indicated, that the patient’s strength may be sus- 
tained. 
833. In many instances the only way to cure synovial inflam- 
mation is to allow the joint to rest and stiffen, the loss of motion 
of the knee-joint being more than compensated by the gain in 
the general health. The constant movement of the joint keeps up 
the irritation and inflammation, and hence it becomes necessary 
to render it immovable. 
834. For this purpose take four pieces of cotton cloth, four 
finger’s breadth wide, and thoroughly saturate them in common 
starch, as prepared for starching linen, and put two thicknesses 
on each side of the leg, keeping it in a straight position. Then 
take a bandage four yards long and fully three finger’s breadth 
wide, and thoroughly saturate it also in the starch, and com- 
mence carefully winding six inches below the knee, allowing the 
bandage to lap at least one-half its width on each turn around the 
limb, and so enclose the entire joint and about six inches above 
it. Continue the leg in this straight line and position until the 
bandage thoroughly dries, and if it has been properly starched, 
rightly applied and correctly bound, it will effectually prevent 
the motion of the joint and allow it rest and opportunity to re- 
cover from inflammation. 
This disease is so serious that it is better to obtain the advice 
of an experienced physician, for if it be mal-treated the result 
may be unfavorable. 
835. Sometimes in treating white swellings it becomes neces- 
sary to resort to amputation in order to save life. In a case to 
which I was called, several years since, the patient, a gentleman of 
about forty years, had been under the best of medical treatment 
for a year and a half, yet the disease had steadily progressed 
until, when called to the case, I found him much emaciated 446 
COMMON SENSE MEDICAL ADVISER. 
and very feeble. He was kept awake by harassing pain and 
tormented by night sweats and hectic fever. Six openings 
(sinuses) in the neighborhood of the knee-joint were discharging 
unhealthy, fetid pus, so profusely as to constitute a drain upon 
his system that was rapidly exhausting his strength, and to 
which his vital powers must, in a few weeks at most, have 
yielded, and death put an end to his suffering had not amputa- 
tion been promptly resorted to. So great was the extent of the 
diseased bone, from which the exhaustive discharge arose, that 
to hesitate in performing amputation was but to trifle with the 
man’s life. Although the physicians who had been treating the 
case admitted that medical treatment could not save his life, and 
that with the best of care he could only live a few weeks longer, 
yet they loudly denounced me when I decided to amputate, 
declaring that the patient was so reduced that he would not sur- 
vive the operation forty-eight hours. I disregarded their strongly 
expressed opinions however, and at the solicitation of the patient, 
decided to cut off the “ offending member.” With the assistance 
of my friend, Dr.W. C. Coburn, Avho superintended the adminis- 
tration of chloroform, I performed amputation about eight inches 
above the knee. Dissection of the knee-joint and surrounding 
parts, afterwards proved that I did not amputate too high, for 
the bone was thoroughly diseased to very nearly the point where 
cut off, while the bones of the joint,which are now in my cabinet 
of morbid specimens, bear conclusive evidence of the sad havoc 
the disease had wrought upon them, and of the necessity of 
amputation as a last resort to save life. He bore the operation 
well and commenced to improve in strength within a week. For 
so much less was the drain upon his system, occasioned by the 
discharge from the stump while it was healing, than that caused 
by the profuse discharge from so many openings of the diseased 
bone, and the terrible pain which he had constantly suffered 
thereby, that a change for the better was plainly marked, by early 
and unmistakable evidences of improvment. So readily did the 
stump heal, and so rapidly did he recover, that the noise made 
by the medical wiseacres who had so loudly denounced me for 
resorting to amputation, was promptly hushed, and one of them 
afterwards apologized to me for his ungentlemanly conduct and 
breach of professional etiquette. In five weeks from the day on RICKETS. 
447 
which amputation was performed the patient was walking about 
on crutches, and a week later visited my office, riding half a mile 
in an ordinary omnibus. By his permission, I will state that the 
subject of the preceding narrative is Mr. C.W. Twist, of Topeka, 
Kansas, who is yet alive, hale and hearty—a living monument to 
well-directed surgical skill. 
RICKETS. (Rachitis.) 
836. Rickets is a scrofulous disease, in which all the functions 
of the system are de- 
ranged, and it finally 
manifests itself in dis- 
ease of the hones. It 
is characterized by a 
softening of the bony 
materials, due to a de- 
ficiency of earthy or 
calcareous matter in 
their composition. In 
extreme cases the bones 
can be bent or twisted in any direction, as illustrated by Fig. 
147. It appears to be a disease incident to cold, damp places, 
ill-lighted and imperfectly ventilated rooms, and it attacks those 
who are uncleanly in their habits. 
837. The Symptoms of rickets are severe pains in the 
bones, especially during the night; febrile movements and pro- 
fuse perspiration, paleness of the face, a sallow and wrinkled 
appearance of the skin and derangement of the digestive organs. 
After a time the body becomes emaciated, the face pale and the 
head unusually large. The bones grow soft and unable to support 
the body; various distortions appear; the extremities of the long 
bones are enlarged, while the limbs between the joints are very 
slender. Rickets is a disease peculiar to childhood, though it 
may not be developed until a more advanced period of life. It 
rarely proves fatal, unless in those instances where the lungs, 
heart or other vital organs are involved. In some instances the 
softening and other symptoms continue to increase, until every 
function is affected and death ensues. 
Fig. U7. 
838. Post-mortem examinations of those who have died of 448 
COMMON SENSE MEDICAL ADVISER. 
rickets have disclosed changes affecting the brain, liver, lym- 
phatic glands, etc. The lungs are often compressed or displaced, 
and the muscles of the body pale and wasted. Sometimes the 
bones are so soft, on account of the deficiency of the calcareous 
deposit, that they can be easily cut with a knife. 
839. Treatment. The use of alteratives, iron tonics, 
and preparations rich in phosphate of lime, are indicated in this 
affection. It is a disease usually developed during childhood, in 
consequence of insufficient exercise, deprivation of the stimulus 
of sunlight, low, innutritious diet, and lack of cleanliness. 
Therefore it is essential to obviate all known causes, and at 
the same time supply the patient with food abounding in those 
elements which the present wants of the system seem to de- 
mand. The importance of this disease requires the employment 
of some experienced physician. But under any plan of treatment, 
it will be necessary to observe the general directions given for 
the hygienic management of scrofula. I might give many 
illustrations of cases of those who have entirely recovered from 
this disease, under my advice and treament, but the rela- 
tive importance of this affection does not really demand the 
evidence. I will therefore say, for the encouragement of the 
afflicted, that this form of scrofula yields to proper medicines, 
and it may be very successfully treated by skilled and experienced 
physicians. 
SCURVY. 
840. Scurvy is a disease which was familiar to the ancients, 
and pre-eminently destructive to life in their armies and navies. 
In consequence of the improvement in hygienic rules, it is not as 
common at the present day, although it contributed not incon- 
siderably to the mortality in our armies during the late civil 
war. Scurvy is undoubtedly due to an impaired condition of 
the blood. This deterioration may be caused by an insufficiency 
of vegetable food. The long-continued use of salted meats, 
unaccompanied by vegetable diet, will induce scurvy. Although 
the diet is one cause of the production of the disease, other 
causes act as powerful aids in establishing this affection. Ex- 
posure to wet and cold and deficient ventilation are favorable to 
its production. CAXCER. 
449 
841. The symptoms of scorbutus, or scurvy, are a sallow ap- 
pearance of the skin, impaired appetite, feeble and slow pulse, and 
dry skin upon which are patches of ecchymosis (black or yellow 
spots). The gums become swollen, soft, of a dark purple color, 
and are liable to bleed; the teeth loosen and the breath is offen- 
sive. As the disease progresses the symptoms increase in seve- 
rity. This malady is more apt to occur during the winter than 
in summer. 
342. Tlae Domestic Treatment of scurvy should 
be of a hygienic character. The patient should partake freely 
of fresh, juicy fruit, such as lemons, oranges, grapes, apples, 
pine-apples, etc. Also of onions, pickles, radishes, water-cresses, 
fresh meats, etc. In short, his diet should be both generous and 
nutritious. 
843. Attention should also be paid to cleanliness, and the 
patient should bathe regularly every day; he should also be in a 
dry atmosphere and have a constant supply of pure air. Con- 
stipation should be relieved by mild laxatives, or if suffering 
from diarrhoea the patient should use moderate astringents, or 
my Extract of Smart-Weed. 
CANCER. 
844. Cancers are malignant affections manifested in the for- 
mation of morbid growths, which have a disposition to spread 
and involve contiguous tissues, and at some stage of their exist- 
ence ulcerate and become hideous open sores. There are several 
varieties of cancers, all of wdiich possess the above character- 
istics, as well as others peculiar to each separate variety. Most 
prominent among these are Scirrhus, Encephaloid, Epithelial, 
Colloid, Melanoid and Osteoid. The three latter are sometimes 
included with some other varieties, under one general head— 
mixed. In common parlance, the different kinds of cancers are 
named from a fancied resemblance to some object, or to the 
character of the object, as stone, rose, spider, wolf or black can- 
cers; or from the locality in which they appear,—as lip, breast, 
womb, skin, or bone cancers. These different varieties may exist 
separately, or may be combined, so that several varieties may 
appear in a single growth; or according to J. Hughes Bennett, 
Frank H. Hamilton and others, they are sometimes transformed 450 
COMMON SENSE MEDICAL ADVISER. 
one into another. In consequence, it is sometimes very difficult 
to distinguish and classify them. The cancer-cells present almost 
every conceivable shape, as round, oval, caudate, spindle-shaped, 
heart-shaped, oblong, square, etc., and vary greatly in their size 
—from xinnr to an inch in diameter. In some form or 
other, cancers are met with at all stages of human existence, from 
infancy to old age. 
845. It attacks, by preference, particular structures, though 
none are exempt from its ravages. It occurs more frequently in 
females than in males. The structure of the womb and breast, 
particularly the former, being favorable to its development, 
accounts for the greater frequency of its occurrence in women. 
846. Causes. Regarding the cause of cancer, but little is 
known. There is no doubt that its development is due to per- 
verted nutrition in the part where it occurs, but the nature or 
cause of this perversion is a mystery. It is quite currently 
believed that there may be a constitutional predisposition to can- 
cer, which is either hereditary or acquired. It is a matter of 
dispute whether it is ever hereditary, or whether its occurrence is 
accidental; certainly only a limited number are met with among 
children whose parents have had cancer; while numerous cases 
are found in which there is no evidence of hereditary origin. It 
is also a matter of dispute whether the constitutional affection 
existing conjointly with the local disease, sustains the relation of 
cause or of effect. Certain it is that a characteristic constitu- 
tional derangement exists at some stage of its progress; though 
it may be doubtful if either the local or constitutional cause 
would be sufficient to produce the disease, without the aid of the 
other. 
Some eminent pathologists claim that this perverted cell 
growth, which constitutes cancer, is simply the result of an injury 
inflicted upon the part where the future cancer appears, and that 
the constitutional affection is the effect of this perverted cell 
growth, or of their fluids entering the circulation. Others claim 
that the constitutional affection must exist prior to the local, and 
that the local disease is determined to the particular locality where 
it is observed, by any irritation or injury sustained at that point. 
847. My own opinion inclines to the existence of the consti- 
tutional condition, as a cause rather than as an effect, for the CAXC32R. 
451 
reason that the number of injuries resulting in cancer is but a 
very small fraction of the whole number of injuries sustained, 
while many cancers cannot be traced to any local cause whatever. 
This view is strengthened also by the great tendency of the local 
disease to re-appear after its removal; though no doubt those 
who entertain the local theory will attempt to account for this 
fact, by the statement that the whole of the local affection was 
not removed; or that the ulcerative process had infected the 
system prior to its removal. This latter, however, is blit a 
partial admission of the constitutional theory of the disease. 
By some, cancer is supposed to be transmitted by direct con- 
tagion, and some very plausible arguments have been advanced to 
substantiate the belief, one of which is the fact, that when the wife 
has cancer of the womb, the husband sometimes has cancer of 
the penis, and vice versa. It is not proven, however, that this 
fact is any thing more than a coincidence. When the cancerous 
disposition is once established, any thing which depresses the 
powers of life, renders the system less able to resist disease, and 
indirectly favors the development of the local sore. There is no 
doubt that any irritation increases the activity of cancer, and it 
is generally believed that morbid growths, which are essentially 
benign, in consequence of irritation and interference may take 
on a peculiar degeneration and become malignant. 
848. Symptoms. Cancers are characterized by the pres- 
ence of morbid growths, which show a decided tendency to 
spread and invole surrounding tissues. The pain experienced, 
which is usually severe and agonizing, is peculiar in its character, 
stinging, biting, sharp, and lancinating, generally occurring in 
paroxysms, and in the advanced stages of the disease is nearly 
continuous, the patient getting but little rest. In the earlier 
stages, pain is sometimes absent. After a time, the growth 
ulcerates and gives rise to exhaustive discharges, and in many 
cases to attacks of profuse hemorrhage. As the disease pro- 
gresses, the countenance presents a peculiar appearance, sallow, 
sodden, or grayish yellow, which is called the cancerous cachexy. 
The patient becomes despondent, the general health is deranged, 
and life is beset on every side by this unrelenting foe, and he 
dies worn out by the pain and exhaustive discharges, literally 
fretted and stung to death. 452 
COMMON SENSE MEDICAL ADVISER. 
While the general appeai’ance and symptoms are common to 
all, each different variety possesses characteristics peculiar to 
itself, some of which we will briefly notice. 
849. Scirrll!l§. This variety is also known as hard, 
stone or rock cancer, from its extraordinary hardness, which is 
not surpassed by any constituent of the body except bone. It 
rarely occurs until after middle age, generally from forty-five to 
fifty, though occasionally developing in those much younger. It 
is most frequently met with among females, and oftenest occurs 
with them about the time of the cessation of the menses. It 
attacks, by preference, the womb, breast, anus, liver, stomach, 
colon and rectum. It imparts a dense, inelastic, incompressible, 
stony sensation to the touch; is sometimes nodulated, and at first 
is circumscribed and movable under the skin. At' a later period 
it contracts adhesions to the surrounding parts and is thus firmly 
fixed. After a time the skin over the tumor becomes depressed 
at its most salient point, and is dark, purple or shining, and finally 
dries, cracks, or suppurates and opens, leaving an ulcer, which in- 
creases in size and becomes irregularly shaped and deeply exca- 
vated, attended by profuse, irritating and exhaustive discharges. 
Neighboring glands become involved, those nearest it becoming 
first affected. This variety of cancer is slow in its progress, and 
may run for a long time before active symptoms are manifested. 
Its average duration is about three years. 
850. EpitlieliOEHasa. This variety was formerly classed 
as Scirrhus, which it resembles, and at the present day many 
consider it as a less malignant form of that variety. It gener- 
ally attacks mucous or cutaneous surfaces, though it is not limited 
to these tissues. Its progress is usually slow. It generally 
occurs after the fortieth year, though it is occasionally met with 
prior to thirty, and is most frequent in males. It most com- 
monly occurs upon the lips, tongue, gums, face, vagina, anus, 
penis, and scrotum, but is not restricted to these localities. It 
generally begins with a crack, tubercle, or wart, which is hard 
to the touch, at first movable and tender on pressure. By and 
by ulceration sets in, sometimes at several points at once, and 
leaves a foul, unhealthy fungus appearance, with irregular edges, 
and a hard, rough base, from which issues an abundant discharge 
of a thin, sanious, corroding character. The pain in this variety CANCER. 
453 
is generally burning, darting, and pricking. Long continued 
irritation, no doubt, contributes to its development. Their 
removal, when performed early, is attended with greater success 
than that of any other variety. 
851. Eaiceplialoid, or Medullary. This is also 
known as soft cancer, and is “ brain-like ” in its appearance and 
consistence. Rapid in its progress, it destroys life in from six to 
twelve months. It occurs in either sex and at all stages of life 
from infancy to old age. It most frequently occurs in the 
breast, eye, testicle, and uterus, though it may occur in any 
tissue. This variety is bountifully supplied with blood-vessels, 
and, in some cases, they throw out a prolific fungus, which is 
subject to constantly recurring and profuse hemorrhages. When 
it presents this form it is denominated fungus hcematodes, and is 
popularly known as rose cancer. It commences as a soft, round, 
sometimes lobulated, elastic tumor, which is not circumscribed, 
but blended with the surrounding tissue, its base broader than its 
summit. The sensation communicated by the touch shows it to be 
peculiarly soft, elastic, and fluctuating, as if it contained matter. 
The surface soon assumes a mottled, purple, or shining appear- 
ance. It soon ulcerates and becomes an open sore, which is 
generally filled with a bloody fungus. Prior to the ulceration, 
the pain is fitful and throbbing, and not so severe or lancinating 
as in Scirrhus. 
852. Colloid or Gelatilliform, also known as En- 
cysted, jelly-like, or gum cancer, occurs most frequently in the 
ovaries, stomach, omentum, and large intestines. It generally 
grows rapidly and to a very great size. It is often associated 
with the Scirrhus and Medullary varieties, when its malignancy 
is intensified. But when pure, as frequently happens in the 
ovaries, it is the least malignant of any of the cancerous growths; 
it is generally destructive to life on account of its enormous size 
and pressure, rather than from the infection of the system, or 
the extension of the disease to other parts. In this variety, the 
jelly-like substance is contained in fibrous cells, giving it very 
much the appearance of honey in the comb, some parts being 
denser than others. It has less disposition to ulcerate, is not 
painful only from pressure, and consequently its diagnosis and 
classification is attended with difficulty. It may occur in both 454 
COMMON SENSE MEDICAL ADVISER. 
sexes, and at all periods of life, though most frequently between 
the ages of thirty-five and fifty. 
853. Melaiioid. This is also called black cancer. When- 
ever black pigment enters into the structure of cancer, it gives it 
the peculiar appearance known as Melanoid. This most fre- 
quently happens to the Encephaloid variety, of which it is con- 
sidered but a modification. 
854. Osteoid Cancer. This is also called bone cancer. 
It may be a cancerous outgrowth of bone, or occur within the 
structure of the bone itself. It consists of the Scirrhus or En- 
cephaloid varieties. The bones most liable to cancerous affec- 
tions are the superior maxillary, the femur and tibia in the vicin- 
ity of the knee-joint, and the humerus, though any bone may 
become affected. The growth of these tumors is generally rapid; 
they are of an irregularly globular form, and accompanied with 
intense pain. After they have attained considerable size, the skin 
presents a tense, shining appearance, of a reddish or purple color. 
855. other Varieties. Most authors enumerate sev- 
eral other varieties of cancerous disease, but as they are simply 
modifications of those already considered, they will be omitted 
here. 
856. Curability. While we acknowledge the great 
fatality attending this disease, it must not be denied that cancers 
are frequently cured. Much of the evidence on this subject, 
coming as it does, from men who are accepted by the profession 
at large as reliable authority, gives additional weight to my 
own belief. As to whether the cases referred to were really 
cancers or not, there is no reason for doubt. Everything that 
science could do to establish a correct diagnosis was done, not 
omitting microscopical examinations of the substance of the 
cancers themselves, by eminent microscopists, who it is be- 
lieved were not biased in favor of establishing perverted views 
of the curability of the disease in question. 
857. Professor Bennett, of Edinburgh, states that they are 
curable at certain stages, and says that they have sloughed out 
and healed of themselves. Velpau, of Paris, also furnishes evi- 
dence, which is sufficient of itself to prove the curability of the 
disease. His observations extend over a great many years, and 
in addition to the positive diagnosis made by him, he has watched CASTCEll. 
455 
the results in hundreds of cases, where the cures were perfect 
and remained so for a period of time, varying from five to 
twenty-five years. Some of these cases were truly remarkable. 
In 1854 he published a work on the subject, setting forth the 
results of his labors. In 1864, in a letter to Professor Bennett, 
lie refers to the above matter, and also states that in addition to 
the cases published in 1854, he then had 991 more to be added 
in confirmation of his previous views. 
858. The greater portion of the medical profession have been 
very slow to acknowledge the curability of cancer, a fact which 
quacks have not been slow to perceive and take advantage of. 
Consequently there is scarcely a city of any considerable size in 
the United States that has not its so-called “ cancer doctor.” 
The people have cancers, and, if respectable practitioners cannot 
promise to cure, and decline to treat them, they look for some 
one who will at least make the attempt. This is precisely what 
the quacks want, and people flock to them in great numbers. 
Generally the knowledge which these self-styled “ doctors ” 
possess of the pathology of the disease, and its correct treatment, 
is very little, and when a genuine cancer patient is so unfortu- 
nate as to fall into their hands, he generally dies. 
Warts, wens, tumors and sores of all kinds, large or small, 
benign or malignant, always become cancers at the first consul- 
tation with these quacks, and their removal a matter of life or 
death. These comparatively innocent growths furnish specimens 
of the skill of the operator, and the efficacy of his treatment. 
When business is slack, or a “ cancer doctor ” wants to start in 
trade, and he has not a sufficiently imposing array of specimens 
to scare his victims into the belief that they have a “ cancer,” 
pieces of tough and gristly beef, selected from various portions 
of the animal, well bruised, dipped in hot water, and then 
“ pickled ” in alcohol, quickly supply the deficiency. 
To show the trickery of these fellows, I would state that one 
of my friends once consulted a noted “cancer doctor” about 
a morbid growth in the side. It had never occasioned any in- 
convenience, and had been repeatedly diagnosed as an innocent 
tumor. lie at once decided that it was a “ cancer of the most 
malignant kind,” and if not removed, would result in death in 
less than six months. Alas! the patient’s pocket! there was not 456 
COMMON SENSE MEDICAL ADVISER. 
money enough in it to secure the quack’s services, and the 
removal of the tnmor had to be effected by a surgeon, whose 
diagnosis of simple fatty tumor was confirmed by examination 
after the operation. The patient speedily recovered, and remains 
so to this day. Another one, suffering from epithelial cancer of 
the lip, consulted the same impostor, and was not so fortunate. 
One hundred dollars was the fee asked, and the cure guaranteed! 
The cancer was partially removed with caustic, and in three 
months it was much worse than ever. The patient then returned 
to the “ doctor,” and he refused to recognize him or do any thing 
more for him. The result was, the patient died, but the “ doctor” 
got his fee. 
859. From time to time, nostrums without number have been 
offered to the public for the eradication of cancer, without local 
interference. All of the “ sarsaparillas,” and nearly all of the 
“ alteratives ” and “ bitters,” that have been manufactured and 
sold as patent medicines, have been advertised to cure every- 
thing, cancer included. The very fact that such a claim i3 made, 
should be sufficient to stamp “ humbug ! ” in flaming characters 
upon every one of them. Various other remedies, the composition 
of which is not a secret, have been lauded as specifics for cancer, 
among which is the famous cundurango, but none of them have 
stood the test of practical experience. 
860. I would urge all who are affected with morbid growths, 
or sores of a suspicious character, to attend to them early, bear- 
ing in mind that the sooner proper treatment is instituted, the 
greater will be the probability of a cure; for some of those 
growths, which are not actually cancerous, may, if left to degen- 
erate, become so. In seeking for a cure, above all things do not 
lose time in running after impostors. The country is full of 
them. They will not give you the chance the highwayman does 
who demands—“your money or your life,”—but will take both. 
Go to some physician in whom you have confidence, whose repu- 
tation for ability and integrity are above reproach, and who will 
deal honorably and candidly with you. 
8G1. Treatment. The treatment of cancer is very prop- 
erly divided into curative and palliative; curative, when the 
treatment is undertaken with a view to remove the local disease, 
and prevent its return, and to remedy the constitutional dyscrasia CANCEK. 
457 
(bad habit of the body); palliative, when for any reason a 
cure is out of the question, and treatment is instituted for the 
purpose of retarding the progress of the disease, and affording 
present relief. 
862. The curative treatment then will be based upon the fol- 
lowing indications: 
(1.) To overcome the constitutional dyscrasia. 
(2.) To remove the local affection. 
To carry out the first indication, everything should be done to 
secure a healthy performance of all the functions of the body, 
and increase the powers of life. Nutrition and assimilation must 
be improved, that perfect reparative materials may be elabor- 
ated; the blood enriched and purified, all morbid materials being- 
removed to prevent their localization. Pain must be relieved, 
as it wears the patient out in spite of all other measures. We 
must inculcate perfect hygiene, proper attention to all the laws 
of health, which have been fully considered in the chapters on that 
subject. As we improve the health — no matter how,— just so 
much do we retard the progress of the disease. In cancer, the 
better the general health, the slower the local disease progresses. 
863. While I have never advertised my Golden Medical Dis- 
covery as a specific for cancer and never intend to, yet for the 
purpose of renovating the constitution, removing impurities from 
the system,improving nutrition and bringing about a more perfect 
condition of life, I believe it to be unequaled. So far as this 
goes towards a cure, my Discovery is curative. I do not, how- 
ever, expect it to fulfill both indications, nor advise it with such 
a view. 
It aids in the perfect performance of all the various processes 
of life, and I have seen remarkably beneficial results follow its 
employment. 
864. To fulfill tlie second indication — to remove the local 
affection — is a very weighty consideration, and success will 
in a very great measure depend upon their location, and the 
structures involved. Their removal is generally accomplished 
by the use of caustics or the knife; and when undertaken must 
be thoroughly and perfectly done, or the disease will acquire in- 
creased impetus from the irritation produced. Mild measures 
are worse than useless. Cancers must never be tampered with. 458 
COMMON SENSE MEDICAL ADVISEE. 
There is no middle ground; they must either be let alone or 
effectually removed. As their removal can only be successfully 
accomplished by personal attention and the greatest skill, I shall 
not advise any of the agents I employ, for fear that in non-pro- 
fessional and incompetent hands they might be productive of 
harm. 
865. I must here refer to a “ dodge ” quite prevalent among 
“ cancer doctors.” They advertise to “ cure cancers without 
pain ” and “ without the use of the knife.” In the manner in 
which legs and arms are amputated without pain, and in no 
other way, can cancers be removed without pain. The dis- 
covery of anaesthetics (chloroform and ether) has mitigated the 
terrors of surgery, and by the temporary suspension of sensi- 
bility which they produce, operations are performed without 
pain. But the quack never resorts to anaesthesia and the knife, 
which is the only really painless way in which cancers can be 
removed, but by the use of caustics and poultices he slowly 
disorganizes and sloughs the tumor out. The use of caustics 
requires so long a time, that to keep the patient influenced by 
anaesthetics, while a cancer is being removed by them, would be 
destructive to life. Persons who have been operated on by these 
“ painless doctors ” concur in saying that they experienced the 
most excruciating pain and that for a long time. 
Not that I would in all cases resort to the knife in preference to 
the caustic plan of treatment, for there are various circumstances 
that, in individual cases, would render the destruction of the 
tumor by caustics preferable. Again, I have frequently yielded 
to the feelings of my patients when they had a greater dread of 
the knife than of the slower destruction and sloughing out of 
the tumor, and resorted to the latter method. By a judi- 
cious compounding of anodynes with the caustics used, I have 
rendered their employment as nearly painless as is possible 
and have them accomplish the thorough and complete destruc- 
tion of all the parts involved in the local disease, which is an 
essential to the success of the undertaking. The treatment of 
cancers has entered largely into our practice at the World’s 
Dispensary, and by a large experience with this disease, I have 
become satisfied that, so far as success in curing them is 
concerned, it matters little whether the tumor be removed by CANCER. 
459 
the knife, or by caustics modified by anodynes. The healing of 
the parts after the use of the knife is less tedious than after 
the caustic applications, as the latter leave an irregularly shaped 
excavation in the tissues, while the knife makes clean, regular 
shaped incisions and the edges can be approximated and held in 
apposition by stiches, when they speedily adhere and close the 
wound. 
866. After-Treatment. The constitutional treatment hereto- 
fore advised, should always be perseveringly adhered to after the 
removal of a cancerous tumor. I am confident that the more 
than ordinary immunity from relapses, which my patients have 
enjoyed, has been largely due to the thorough course of consti- 
tutional after-treatment which I have insisted upon their taking. 
The philosophy of this must be readily apparent to all thinking 
minds for reasons already explained. 
867. Palliative Treatment is resorted to when the local afflic- 
tion is where it cannot be extirpated, as in the stomach, where 
it is believed that the operation would hasten fatal results, and 
when the patient declines to have extirpation attempted. It 
consists in improving the general health, remedying the constitu- 
tional condition, thereby retarding the disease. For this pur- 
pose, the advice given under the first indication of the curative 
treatment, is applicable here. Any other conditions which com- 
plicate the case, must be met with such remedies as the character 
of the complication, and the state of the patient demand. No 
general rules can be given for such a malady, which would be 
safe in non-professional hands. 
Pam is often so severe as to demand special attention, and 
must be remedied by anodynes or narcotics. In their selection, 
however, much care should be exercised, and such be chosen as 
neither exert any peculiarly deleterious effects upon the constitu- 
tion of the patient, nor interfere with the processes of life. This 
will no doubt be found a difficult matter by any but an exceed- 
ingly skillful practitioner. When the local affection has become 
an open sore, anodyne and antiseptic dressings should be used, 
which will soothe the irritation and pain, absorb the discharge, 
and prevent it excoriating the surrounding tissues. Nothing of 
a harsh or irritating character is ever admissible. 460 
COMMON SENSE MEDICAL ADVISER. 
THICK NECK. (Goitre.) 
868. Ihis disease, also called Broncliocele, is an enlargement 
of the thyroid gland. This gland lies over and on each side of 
the windpipe, between the pomum adami, or “ Adam’s-apple,” 
and the top of the breast-bone, and resembles in shape a pair of 
saddle-bags. The lobes on each side are quite large, while that 
portion which lies on the outside of the windpipe, and connects 
the two lobes to each other, is thin and narrow. The tumor 
gradually increases in front and laterally, until it produces great 
deformity, and often interferes with respiration and the act of 
swallowing. From its pressing on the blood-vessels running to 
and from the head, there is a constant liability to engorgement 
of blood in the brain, and to apoplexy, epilepsy, etc. When 
broncliocele once makes its appearance it continues increasing in 
size as long as the person lives, unless cured by proper medicines. 
It never disappears spontaneously. These tumors are much 
larger than those not familiar with them would suppose from 
their outward appearance, as they extend under and are bound 
down by the muscles on each side of the neck, so that they 
become embedded in the cellular tissues underneath, while the 
sides of the neck retain, to a considerabe extent, their round and 
even appearance, whereby the real magnitude of the tumor 
is not apparent. Fig. 148 represents the appearance of the 
neck of a person afflicted with this disease. 
The form of the protuberance varies materially 
with different persons, that shown in the en- 
graving being the shape which it ordinarily 
assumes. 
In the process of curing goitre or thick neck, 
the external parts and extreme points of the 
tumor are first absorbed and carried away, 
when the muscles on the side of the neck, 
which have been pressed outward by the mass 
underneath them, immediately regain their true 
position, and, as a matter of course, the sides of the neck lose all 
their former prominence, while in front of the windpipe there is 
no resistance to its projecting outward, but the external skin, for 
if the entire mass was at once removed, the skin for a while 
Fig. Uf8. MUMPS. 
461 
would remain loose after such distension, and form a kind of 
sack or pouch. For these reasons, the tumor in front may often 
appear as large as ever to a casual observer, when, in reality, 
more than half the entire mass has been removed. 
869. 'Treatment. Take my Golden Medical Discovery 
three times a day, in doses of two teaspoonfuls, and if the 
bowels are not thereby kept regular, take one to three of my 
Pleasant Purgative Pellets each day. Apply to the skin over 
and around the tumor, night and morning, the following 
solution, which may be put up by any respectable apothecary. 
Iodine one drachm; iodide of potassa four drachms; dissolve 
in three ounces of soft water. Apply to the tumor with a 
feather and continue its use twice a day until the tumor disap- 
pears. If the parts should become too tender by its use, it may 
be omitted for a single day only, and then used again. It should 
cause the scurf skin to peal off in very small scales, which it will 
do probably a number of times before the tumor will entirely 
disappear. Should the solution directed, not be strong enough 
to produce this effect, add to it a little more of the iodine. 
Merely wetting the skin night and morning will be sufficient. 
The treatment must be persevered in and continued without in- 
termission or interruption. The time necessary to effect a cure 
depends much upon the size of the tumor, a large one requiring 
a much longer period than a small one. The average time, how- 
ever, is from six months to a year. In carrying out the above 
course of treatment, do not omit the use of my Discovery at any 
time for a longer period than one week, and not oftener than once 
in four weeks, and continue the use of the Pellets during the 
omission of the Discovery. The cure largely depends upon a 
thorough and persistent use of the alteratives. 
MUMPS. (Parotitis.) 
870. This is an inflammation of the parotid glands 48), 
and is mostly, though not wholly, confined to children. It is 
often epidemic and manifestly contagious. It usually, though 
not always, appears on both sides of the neck at the same time. 
871. Symptoms. An external movable swelling, just 
below and in front of the ear, near the angle of the jaw, is the 
pi*ominent feature. The enlargement is not circumscribed, but 462 
COMMON SENSE MEDICAL ADVISER. 
hard and painful, and attended with more or less fever, derange- 
ment of the secretions, and difficulty of swallowing. The swell- 
ing increases until the fourth or fifth day, when it gradually 
diminishes, and by the eighth or tenth is entirely gone. Some- 
times the swelling is suddenly translated (metastasis) to the 
breasts, in the female, or the testicles, in the male. 
872. Treatment. Usually but little treatment is neces- 
sary, farther than the avoidance of exposure to cold. If severe or 
painful, with febrile symptoms, a hot foot-bath and small doses 
of my Compound Extract of Smart-Weed in some diaphoretic 
infusion, to induce sweating, with small doses of aconite 596), 
will produce good results. If metastasis threatens (which sel- 
dom happens except on taking cold), resort should be had to 
mild cathartics, the spirit vapor-bath (*1 630), stimulating lini- 
ments to the neck, and warm fomentations 649) to the part 
attacked. If brain symptoms supervene, a physician should be 
summoned. 
BOILS. (Furunculus.) 
873. These annoying affections are hard, prominent, circum- 
scribed, inflamed, suppurating tumors, having their seat in the 
cellular tissue beneath the skin. They vary in size from a pea 
to a hen’s egg, and may occur on any part of the body. The 
color of a boil varies from deep red to mahogany. It is painful, 
tender, advances rapidly to maturity, becomes conical, and finally 
bursts and discharges bloody matter. Through the opening, 
and filling the cavity, may be seen a piece of sloughing cel- 
lular tissue, which is called the core. In from four to fifteen days 
it is all expelled and the sore rapidly heals. The causes .are an 
impure condition of the blood, which generally arises from im- 
perfect action of the liver or kidneys. 
874. Treatment. Hasten suppuration by the aid of 
poultices. Next purify the blood to prevent subsequent returns 
in other parts of the body. For this purpose take my Golden 
Medical Discovery. Tincture of burdock-root (*|f 462) made by 
finely slicing four ounces of the green root and covering it with 
whisky or alcohol, is a reliable remedy for boils, and may be 
taken in teaspooful doses, alternately with the Golden Medical 
Discovery. If the patient is amemic 772), give iron (*[ 618) 
in addition to the foregoing. ACUTE CATARRH, CORYZA AND INFLUENZA. 
463 
CARBUNCLE. (Anthrax.) 
875. These are more malignant, larger and moi-e painful, 
than boils, which they resemble. They may spring from several 
small pimples which extend deep into the tissues, and on the 
surface frequently several small vesicles appear and break. They 
may dischax-ge, through one or sevei-al openings, a thin acrid, 
bloody, or dark-colored fluid. They most freqxiently occur upon 
the back of the neck, back, back part of the limbs, and under 
the ai-ms. Their presence is evidence of a depraved condition of 
the vital powers. These tumors vary in size from one-half an 
inch to six inches in diameter, and rapidly proceed to a gan- 
grenous condition, a grayish slough being detached fi-orn the 
healthy tissue. 
876. Treatment. Invigorate the powers of life by every 
possible means. The bitter tonics 607), quinine 496), and 
iron 618), nutritious diet, pure air, etc., are necessary. Purify 
the blood, to remove the causes of the disease. For this purpose, 
give my Golden Medical Discovery in as large doses as can be 
borne without acting too freely on the bowels. Anodynes 
(1” 479) may be necessary to ovei-come the pain. Poultices are 
useful to encourage the separation of the dead from the living- 
tissues. Antiseptic dressings 500) are beneficial, of which 
cai-bolic acid (T 503) is to be pi-eferred; yeast, however, 501) 
may be employed. 
877. Sometimes powerful caustics, or free incisions, are pro- 
ductive of gratifying results, if followed by appropriate dressings, 
but a resort to these extreme measures should only be had by the 
direction of a physician. 
For a considerable time after the urgent symptoms have sub- 
sided, the Golden Medical Discovery should be used, to purify 
and enrich the blood, and the bitter tonics and iron may be 
alternated with it, or be used conjointly to good advantage. 
ACUTE CATARRH, CORYZA AND INFLUENZA. 
878. Acute Catarrh or Coryza is an inflammation of the lining 
membrane of the nostrils. The first and most prominent chai’- 
acteristic sensation is that of “ stuffing up of the head.” This 
feeling is caused by the swelling of the lining membrane of the 
passages, which has the effect to close them up. This renders it 464 
COMMON SENSE MEDICAL ADVISER. 
difficult to breathe through the nose, and affects the voice very 
unpleasantly. In a day or two the sufferer begins to sneeze and 
the nose discharges copious quantities of clear, hot, acrid liquid 
that often irritates the external orifice, causing it to become very 
sore. Itjs an affection more disagreeable than dangerous, and 
though the sufferer may be conscious of no guilt in the matter, 
it makes him feel “ extremely mean” Some one, who evidently 
has had experience, has written as near as we can remember the 
words: 
“ A cold in the head—what can he thought about, what can be said 
More unbecoming, more ill-bred.” 
In addition to the symptoms already mentioned, there is 
often “ aching of the bones,” dryness of the skin, and a general 
derangement of the secretions. 
879. Influenza. This is an aggravated form of acute 
catarrh, and is frequently epidemic. When generally prevalent, 
it is more severe than in its solitary manifestations, and when 
complicated wTith other disorders pre-existing in the system, 
sometimes proves fatal. Sufferers from consumption, heart dis- 
ease, or any serious derangement of a vital organ, are in great 
danger from an attack of influenza, should it occur. 
880. Symptoms. This acute affection usually com- 
mences with chilly sensations alternating with flushes of heat. 
Sneezing is a common symptom; there is pain in the forehead; 
breathing through the nose is difficult; the eyes are red and 
watery; soreness of the throat is experienced; there is pain in 
the back, nervous irritation, fever, thirst, hoarseness and general 
lassitude. There is cough, at first dry, afterward attended with 
free expectoration. 
881. Causes. The causes of this epidemic are supposed to 
be sudden atmospheric or electric changes. They may or may 
not be perceptible to the senses, yet their effect is painfully ap- 
parent to all. Such causes of disease, however, are beyond 
human control. We may mitigate their effects, but cannot stay 
them in their career. 
882. Treatment. In the milder forms of acute catarrh, 
or coryza, only simple treatment will be required. A hot foot- 
bath, on retiring at night, with a full dose of my Compound CHRONIC NASAL CATARRH. 
465 
Extract of Smart-Weed, to produce free perspiration, will gener- 
ally break up the attack. Should, however, the discharge from 
the nostrils continue troublesome, Dr. Sage’s Catarrh Remedy 
should be fx-eely snuffed four or five times a day, and if the 
bowels are costive, a mild dose of my Pleasant Pui-gative Pellets 
will materially assist in ovei’coming the disease. These means, 
well applied, together with the avoidance of exposure to cold, and 
restriction to a spare vegetable diet, will prove most efficacious. 
In the more severe attacks of Influenza, the most decisive 
measures should be employed. The spirit vapor-bath 630) 
should be administered, to induce profuse sweating, or if the 
means for its application are not at hand, the patient should be 
warmly covered up in bed, and jugs or bottles of hot water 
applied to his feet and sides. My Compound Extract of Smart- 
Weed should be given freely, together with plenty of warm 
drinks, by which copious perspiration will be kept up, the circu- 
lation of the blood equalized, and inflammation of the mucous 
lining of the air passages subdued. In very severe attacks, the 
tincture or fluid extract of veratrum 597) will aid in estab- 
lishing perspiration and subduing the inflammation. If severe 
coughing is a troublesome symptom, my Golden Medical Dis- 
covery should be taken in small and frequent doses. 
883. In consequence of repeated attacks of acute catarrh, or 
“ cold in the head,” as it is usually termed, the mucous mem- 
brane of the nose, and air passages of the head, become perma- 
nently thickened, the mucous follicles or glands diseased, and 
their functions either destroyed, or very much deranged. Al- 
though chronic catarrh is most commonly brought on in the 
manner above stated, it sometimes makes its appearance as a 
sequel and result of typhoid fever, scarlet fever, measles or other 
eruptive fevers, or shows itself as a local manifestation of 
scrofulous or syphilitic taints in the system. In the early stages 
of the disease the patient may be annoyed with “ only a slight 
dropping in the throat,” as many express it, the amount of the 
discharge from the air passages of the head at this stage of the 
disease being only slightly in excess of health. In some cases 
the discharge is thick, ropy, and tough, requiring frequent and 
CHRONIC NASAL CATARRH. (Oz^ena.) 466 
COMMON SENSE MEDICAL ADVISER. 
strong efforts in the way of blowing and spitting, to remove it 
from the throat, where it frequently lodges. In other cases, or 
in other stages of the same case, the discharge is thin, watery, 
acrid, irritating and profuse. The nose may be “stopped up” 
from the swollen and thickened condition of the lining mucous 
membrane so as to necessitate respiration through the mouth, 
giving to the voice a disagreeable nasal twang. From the 
nature of the obstruction in this condition, it is useless for the 
sufferer to endeavor to clear the passage by blowing the nose; 
this only tends to render a bad matter worse, by increasing the 
irritation and swelling of the already thickened lining mem- 
brane. The swelling of the mucous membrane does not in all 
cases become so great as to cause obstruction to respiration 
through the affected passages. In some cases, the patient suffers 
from headache a great portion of the time, or may experience a 
dull, heavy, disagreeable fullness or pi-essure in the head, with a 
confusion of his ideas, which renders him quite unfit for business, 
especially such as requires deep thought and mental labor. 
Memory may be more or less affected, and the disposition of 
those who are otherwise amiable, is often rendered irritable, or 
morose and despondent. The mental faculties suffer to such an 
extent in some cases as to result in insanity. The sense of smell is 
in many cases impaired,and sometimes entirely lost, and the senses 
of taste and hearing are not unfrequently more or less affected. 
884. OZcCUa. The ulcerative or more aggravated stage of 
the disease, from the offensive odor that frequently attends it, 
is denominated Ozsena. 
The secretion which is thrown out in the more advanced 
stages of chronic catarrh becomes so acrid, unhealthy and poi- 
sonous, that it produces severe irritation and inflammation, which 
are followed by excoriation and ulceration of the delicate lining 
membrane of the air passages in the head. Although com- 
mencing in the lining membrane, the ulcerative process eats 
away and gradually extends in depth, until it frequently involves 
all the component structures of the nose—cartilage and bone, as 
well as fibrous tissues. As the ulceration extends up among the 
small bones, the discharge generally becomes profuse and often 
excessively fetid, requires the frequent use of the handkerchief, 
and renders the poor sufferer disagreeable both to himself and CHRONIC NASAL CATARRH. 
467 
those with whom he associates. Thick, tough, brownish incrus- 
tations, or hardened lumps, are many times formed in the head, 
by the evaporation of the watery portion of the discharge. These 
lumps are sometimes so large and tough that it is with great 
difficulty that they can be removed. They are usually discharged 
every second, fourth, or fifth day, but only to be succeeded by 
another crop. Portions of cartilage and bone, or even entire 
bones, often die, slough away and are discharged, either in large 
flakes or blackened, half-decayed and crumbly pieces, or, as is 
much more commonly the case, in the form of numerous minute 
particles, that escape with the discharge, and are unobserved. 
It is painfully unpleasant to witness the ravages of this terrible 
disease, and observe the extent to which it sometimes progresses. 
Holes are eaten through the roof of the mouth, and great cavities 
excavated into the solid bones of the face; in such cases only 
the best and most thorough treatment will check the progress 
and fatal termination of the disease. 
COMPLICATIONS. 
885. Catarrh, or ozaena, is liable to be complicated not only by 
the system, blood and fluids suffering from scrofulous or other 
taints, as has already been pointed out, but also by an extension 
of the diseased condition to other parts beyond the air passages 
of the head. 
886. Disease Of the Throat. The acrid, irritating 
and poisonous discharge whioh, in some stages of the disease, 
almost constantly runs down over the delicate lining membrane 
of the pharynx (or throat), is liable to produce in the lining 
membrane a diseased condition similar to that existing in the air 
passages of the head. The throat may feel dry, husky and at 
times slightly sore or raw; or, from the muco-purulent discharge 
that is almost constantly dropping down over its surface, the 
patient may feel very little inconvenience from the disease of the 
throat until it is far advanced — the moistening and lubricating 
effect of the matter that drops on the surface tending to blunt 
the sensibility of the parts. The back of the throat may be pale, 
or of a dark red color. In the advanced stages its surface will 
be studded with very small ulcers, which, as seen through the 
mouth, look like small pimples or “ canker sores,” for which they 468 
COMMON SENSE MEDICAL ADVISER. 
are often mistaken. The patient may at times experience a tick- 
ling sensation in the throat, with perhaps a slight cough. The 
voice may be more or less affected, especially on exposure to cold 
or through over exertion. The tonsils often participate in the 
diseased condition, becoming more or less enlarged from the or- 
ganization of the plastic matter, thrown out from the substance 
of these glands by the inflammatory process. 
887. Extension of the Disease to the Lar- 
ynx. The larynx is that portion of the air passages which, in 
the male, is indicated by “Adam’s-apple.” The acrid, poisonous 
discharge which drops into the throat from the head, is not all 
removed by hawking and spitting. More or less of it is, by the 
act of inspiration, drawn into the larynx, or still lower down into 
the trachea (or wind-pipe). In this way the disease creeps along 
the continuous mucous surface of the air passages, the acrid, 
poisonous discharge arousing in its track the same irritation, in- 
flammation, thickening and ulceration of the lining membrane, 
which characterize the disease in other portions of the air pass- 
ages. When affecting the larynx the case is usually attended 
with more or less of a cough, which is sometimes very severe, at 
other times only a slight hacking. Tenderness in these regions, 
more or less hoarseness, and loss or partial suppression of voice, 
are common to this stage of the disease. 
888. Bronchitis and Consumption. We have 
already detailed the manner in which the throat, larynx and 
trachea, in succession, become affected from catarrh or ozaena. 
By the same process of extension, the bronchial tubes, and lastly 
the parenchyma or substance of the lungs, in their turn, are dis- 
eased, and bronchitis and consumption firmly established. Tight- 
ness in the chest, with difficulty of breathing, soreness, dai’ting, 
sharp, or dull, heavy pain, or a prickly, distressing sensation 
accompanied with more or less cough or expectoration, are evi- 
dence that the bronchial tubes have become affected, and should 
admonish the sufferer that he is now standing upon the stepping- 
stone to consumption, over which thousands annually tread, in 
their slow yet sure journey to the grave. 
889. Deafness. By means of a small canal called tlie 
eustacliian tube, an air passage and* communication between the 
throat and middle ear (Fig. 03, 138, 140) is formed. This CHRONIC NASAL CATARRH. 
469 
passage is lined by a continuation of the mucous membrane which 
covers the throat and nasal passages. The catarrhal inflammatory 
pi’ocess, by continuity of surface, follows the mucous membrane, 
thickening its structure until the eustachian tube is closed and 
the beautiful mechanism of the internal ear is rendered useless. 
While the thickening of the lining mucous membrane is going 
on, and the passage is gradually becoming closed (and this pro- 
cess sometimes extends through several years), the patient will 
occasionally, while blowing the nose, experience a crackling- 
sound in one or both ears, and hearing becomes dull, but returns 
suddenly, accompanied with a snapping sound. This may be 
repeated many times, until, finally, hearing does not return, but 
remains permanently injured. In <other cases,the hearing is lost so 
gradually that a considerable degree of deafness may exist before 
the person is really aware of the fact. Either condition is often 
accompanied with noises in the head, of every conceivable des- 
cription, increasing the distress of the sufferer. The delicate 
bones of the ear are sometimes detached from their articulations, 
the drum ulcerated and perforated, and through the orifice thus 
made, the bones or small spicula may escape with the thick, 
purulent, and offensive discharge. , 
890. Closure of the Tear Duel. The lachrymo- 
nasal duct (“ tear duct ”) or passage, which, when in a healthy 
condition, serves to convey the tears from the eye into the nose, 
may be closed by the same inflammatory and thickening process 
which I have already explained. This condition is usually 
attended with watering and weak eyes, the tears escaping over 
the cheeks, and sometimes producing irritation and excoriation. 
The nasal branch of the ophthalmic nerve sometimes participates 
in the ulcerative process going on in the head, so that the 
eyes are sympathetically affected. They sometimes • become 
congested or inflamed, and sharp pain in the eye-balls may be 
complained of. 
891. Indigestion, Dyspepsia, etc. A large portion 
of the acrid, poisonous, purulent discharge, which drops into the 
throat during sleep, is swallowed. This disturbs the functions 
of the stomach, causing weakness of that organ, and producing 
indigestion, dyspepsia, nausea, and loss of appetite. Many suf- 
ferers complain of a very distressing “ gnawing sensation ” in the 470 
COMMON SENSE MEDICAL ADVISEE. 
stomach, or an ‘‘all gone” or “faint feeling,” as they often 
express it. 
892. Symptoms. Dull, heavy headache through the 
temples and above the eyes, indisposition to exercise, difficulty of 
thinking or reasoning, or concentrating the mind upon any sub- 
ject, lassitude, indifference respecting business, lack of ambition 
or energy, obstruction of nasal passages, discharges voluntarily 
falling into the throat, sometimes profuse, watery, acrid, thick 
and tenacious mucus, purulent, muco-purulent, bloody, concrete 
blood and pus, putrid, offensive, etc. In others, a dryness of the 
nasal passages, dry, watery, weak or inflamed eyes, ringing in the 
ears, deafness, discharge from the ears, hawking and coughing to 
clear the throat, ulcerations, death and decay of bones, expectora- 
tion of putrid matter, spicula of bones, scabs from ulcers leaving 
surface raw, constant desire to clear the nose and throat, voice 
altered, nasal twang, offensive breath, impairment or total depri- 
vation of the sense of smell and taste, dizziness, mental depres- 
sion, loss of appetite, nausea, indigestion, dyspepsia, enlarged 
tonsils, raw throat, tickling cough, difficulty in speaking plainly, 
general debility, idiocy and insanity. 
All the above symptoms, as well as some others which have 
been given previously, and which it is not necessary here to 
repeat, are common to this disease in some of its stages or com- 
plications, yet thousands of cases annually terminate in consump- 
tion or chronic bronchitis, and end in the grave, without ever 
having manifested one-half of the symptoms enumerated. 
893. Varieties. People often suppose that there are a 
great many varieties or species of catarrh. This is an error. 
The nature of the disease is the same in all cases, the symptoms 
only varying with the different stages of the disorder, and the 
various-complicated diseased conditions which are liable to arise, 
and which I have already pointed out. 
894. Causes. Anything which debilitates the system, 
diminishes its powers of evolving animal heat and withstanding 
cold or sudden changes of atmospheric temperature and other 
disease-producing agencies, renders the individual thus en- 
feebled very liable to catarrh. Among the most common debili- 
tating agencies are a scrofulous condition of the system, or other 
impurities of the blood, exhaustive fevers and other prostrating CHRONIC NASAL CATARRH. 
471 
acute diseases, or those badly treated; exhaustive and unnatural 
discharges, intemperance, excessive study, self-abuse, adversity, 
grief, want of sleep, syphilitic taints of the system, which may 
have been contracted unknowingly, or may have been inherited, 
having perhaps been handed down,, even unto the third or fourth 
generation, to an innocent posterity from infected progenitors; 
too sudden rest after great and fatiguing exercise, and living in 
poorly ventilated apartments. These are among the most fruit- 
ful causes of those feeble, deranged or impure conditions of the 
system to which catarrh so frequently owes its origin. Although 
the immediate or exciting cause is generally repeated attacks of 
“ cold in the head,” which being neglected or improperly treated 
“ go on from bad to worse,” yet the predisposing or real cause 
of the disease is, in the majority of cases, an enfeebled, impure, 
or otherwise faulty condition of the system which invites the 
disease, and needs only the irritation produced in the nasal pas- 
sages by an attack of cold, to kindle the flame and establish the 
loathsome malady. Some people are convinced with difficulty 
that there exists in their system a weakness, impurity or de- 
rangement of any kind which permitted the disease to fasten 
itself upon them. They may not feel any great weakness, may 
not have any pimples, blotches, eruptions, swellings or ulcers 
upon their whole person; in fact, nothing about them that 
would, except to the skilled eye of the practical and experienced 
physician, indicate that their system was weakened or deranged 
with bad humors, and yet such a fault may and generally does 
exist. As an ulcer upon the leg, or a “ fever-sore,” or an erup- 
tion upon the skin, may be the only outward sign of a fault in 
the system, so, frequently chronic catarrh is the only sign by 
which a bad condition of the system manifests itself in a manner 
that is perceptible to the sufferer himself or to the non-profes- 
sional observer. The finely-skilled physician, whose constant 
practice makes his perceptive faculties perfect in this direction, 
would detect the constitutional fault, as an experienced banker 
detects a finely executed and dangerous bank-note which the un- 
practiced eye would receive as genuine. 
895. Treatment. If you would remove an evil strike at 
its root. As the predisposing or real cause of catarrh is, in the 
majority of cases, some weakness, impurity or otherwise faulty 472 
COMMON SENSE MEDICAL ADVISEE. 
condition of the system, in attempting to cure the disease our 
chief aim must be directed to the removal of that cause. The 
more I see of this odious disease, the more do I see the import- 
ance of combining, with the use of a local, soothing and healing 
application, a thorough and persistent internal use of blood- 
cleansing and tonic medicines. 
As a local application for healing the diseased condition in the 
head, Dr. Sage’s Catarrh Remedy is beyond all comparison the 
best preparation ever invented. It is mild and pleasant to use, 
producing no smarting or pain, and containing no strong irritating 
or caustic drug, or other poison. Its ingredients are simple and 
harmless, yet when scientifically and skillfully combined in just 
the right proportions, they form a most wonderful and valuable 
healing medicine. Like gunpowder, which is formed of a com- 
bination of saltpetre, sulphur and charcoal, the ingredients are 
simple, but the product of their combination is wonderful in its 
effects. This Remedy is a powerful antiseptic, and speedily de- 
stroys all bad smell which accompanies so many cases of catarrh, 
thus affording great comfort to those who suffer from this disease. 
The reader’s mind cannot be too strongly impressed with the 
importance of combining thorough constitutional with the local 
treatment of this disease. Not only will the cure be thus more 
surely, speedily and permanently effected, but you thereby guard 
against other forms of disease breaking out as the result of 
humors in the blood or constitutional derangements or weakness. 
In curing catarrh and all the various diseases with which 
it is so frequently complicated, as throat, bronchial and lung 
diseases, weak stomach, catarrhal deafness, weak or inflamed 
eyes, impure blood, scrofulous and syphilitic taints, the wonderful 
powers and virtues of the Golden Medical Discovery cannot be 
too strongly extolled. It has a specific effect upon the lining 
mucous membranes of the nasal and other air passages, pro- 
moting the natural secretion of their follicles and glands, thereby 
softening and restoring the diseased and thickened membrane to 
its natural thin, delicate, moist, healthy condition. As a blood 
purifier, it is unsurpassed. As those diseases which complicate 
catarrh are diseases of the lining mucous membranes or of the 
blood, it will readily be seen why this medicine is so well 
calculated to cure them. CHRONIC NASAL CATARRH 
473 
896. The Golden Medical Discovery is the natural “help- 
mate ” of Dr. Sage’s Catarrh Remedy. It not only cleanses, 
purifies, regulates and builds up the system to a healthy standard, 
and conquers throat, bronchial and lung complications when any 
such exist, but from its specific effects upon the lining membrane 
of the nasal passages it aids materially in restoring the diseased, 
thickened or ulcerated membrane to a healthy condition, and 
thus eradicates the disease. When a cure is effected in this 
manner it is permanent. The system is so purified, regulated 
and strengthened as to be strongly fortified against the encroach- 
ments of catarrh and other diseases. In taking Golden Medical 
Discovery the effects upon the system will be gradual, and the 
alterative changes of tissue and function generally somewhat 
slow. They are not, however, less complete, radical and lasting, 
and this constitutes its great merit. Under its use all the 
secretions are aroused to carry the blood poisons out of the 
system, the nutrition is promoted, and the patient finds himself 
gradually improving in flesh; his strength is built up, his linger- 
ing ailments dwindle away, and, by and by, he finds his whole 
person has been entirely renovated and repaired, and he feels 
like a new man—a perfect being. 
897. The Clothing. With most persons suffering 
from chronic nasal catarrh, there is a great disposition to take 
cold, even slight causes being sufficient to produce an acute 
attack, which greatly aggravates the chronic affection and ope- 
rates to render it permanent. To obviate the bad effects that 
are liable to result from this predisposition, great attention 
should be paid to the clothing, that it thoroughly protects the 
person from sudden changes of temperature. For more particu- 
lar and practical suggestions in regard to this matter, the reader 
is referred to the article on clothing in Part Third of this 
volume. 
898. The IMet has an important influence with this dis- 
ease, as with consumption and many other chronic ailments. It 
should he largely composed of those articles rich in the non- 
nitrogenized or carbonaceous elements 342). Fat meats, 
rich, sweet cream, good butter and other similar articles of diet, 
should be largely eaten. By furnishing the elements for the 
production of animal heat, they counteract the predisposition to 474 
COMMON SENSE MEDICAL ADVISER. 
take cold, and thus become most valuable remedial agents—not 
less essential than the medical treatment that has been advised. 
The patient, suffering from chronic catarrh, should study well 
the hygienic teachings to be found in Part Third of this volume 
and govern himself accordingly. 
899. Treatment of Complications. There are 
various complications of this disease that require modifications 
of the treatment to meet them successfully. Yet rules cannot 
be made that would enable non-professional readers to vary the 
treatment to suit peculiarities of constitution, or complications of 
the disease. When consulted, either in person or by letter, I 
have been able to so modify the treatment as to adapt it to 
peculiar individual cases which resisted all ordinary treatment, 
and have thus cured hundreds who had otherwise failed to find 
relief. 
900. Time Required in Effecting; a Cure. 
Reader, if you suffer from chronic nasal catarrh, do not expect 
to be very speedily cured, especially if your case is one of long 
standing. Unprincipled quacks and charlatans, who possess no 
knowledge of disease, or medicine either, and whose sole design 
is to palm off upon you a bottle or two of some worse than 
worthless, strong, caustic solution, irritating snuff, or drying 
“fumigator,” “dry up,” “annihilator,” “carbolated catarrh 
cure,” “ catarrh specific,” or other strong preparations, will tell 
you that the worst cases can be speedily cured by these unrea- 
sonable means. It is true that such strong, irritating and drying 
preparations will many times suddenly arrest the discharge from 
the nose, but the thickened or ulcerated condition of the lining 
mucous membrane, which really constitutes the disease, is not 
removed by such treatment, and the discharge soon comes on 
again. Besides, there is danger attending the use of such strong, 
irritating or drying preparations. The disease, by their use, is 
frequently driven to the throat, bronchial tubes, lungs, or brain, 
and thus a bad matter is made worse. Not less irrational and 
unsuccessful is the plan of treating the disease with inhalations 
of “ carbolized iodine,” and other drugs, administered through 
variously devised pocket and other inhalers. Such treatment 
may mask or cover up catarrh for a time; but by reason of the 
constitutional nature of the disease, they cannot effect a perfect CHRONIC NASAL CATARRH. 
475 
and permanent cure. Dr. Sage’s Catarrh Remedy, on the other 
hand, cures the disease upon common sense, rational and scien- 
tific principles—by its mild, soothing and healing properties, to 
which the disease gradually yields, when the system has been 
put in perfect order by the use of Golden Medical Discovery. 
This is the only perfectly safe, scientific and successful mode of 
acting upon and healing it. Without, I trust, being considered 
egotistical, I can say that this opinion is based upon a large 
experience and a perfect familiarity with the nature and cura- 
bility of the disease. For a long time my whole time and atten- 
tion has been given to the study and cure of Catarrh and other 
chronic diseases treated of in this volume. Cases of catarrh have 
been treated by thousands, and my medicines for the cure of 
this loathsome disease, and for other chronic diseases, have met 
with an extensive sale in all parts of the United States, and have 
found their way into many foreign countries. The universal 
satisfaction with which their use has been attended, and the 
grateful manifestations received from the cured, have afforded 
one of the greatest pleasures of my life. Scarcely a mail arrives 
that does not bring new testimony of cures effected by the 
treatment heretofore recommended. 
901. Directions for Using Dr. Sage’s Catarrh 
Remedy. To prepare the medicine ready for use, put the 
whole quantity of powder contained in the package as put up for 
sale, into a bottle; pour into it one pint of cold soft water. 
Ordinary lake, river, well or spring-water will do if only slightly 
hard. Cork the bottle tightly and shake it thoroughly, after 
which allow it to stand six or eight hours to settle. Two of the 
ingredients of which the Remedy is composed do not entirely 
dissolve, but their medical properties are completely and speedily 
extracted and taken up by the water. It should be kept tightly 
corked, not allowing it to freeze in winter nor keeping it where it 
is very warm in summer. 
Use the fluid prepared according to the above directions, not 
less than three or four times a day, the last time just before retir- 
ing, in the following manner: Without shaking the bottle to roil 
the fluid, pour out a teaspoonful or more into a spoon or into the 
hollow of the hand; first gently, and afterwards forcibly, snuff 
the fluid up one nostril and then the other, until the nose is well 476 
COMMON SENSE MEDICAL ADVISER. 
filled and it passes back into the throat. No fears need be enter- 
tained of its strangling or producing any unpleasant effect in thus 
using it, for unlike any other fluids (simple tepid water not ex- 
cepted) it does not produce the slightest pain or disagreeable 
feeling, but on the contrary leaves such a cooling, pleasant sen- 
sation, that its use soon becomes a pleasure rather than a task. 
In a few minutes, after thus using the Remedy, it should be blown 
out gently (never forcibly) to clear the nose and throat of all 
hardened crusts, and offensive accumulations, if any such exist. 
This process should be repeated until the Remedy has been 
thoroughly applied two or three times, not blowing it out the last 
time of using it, but retaining the medicine in contact with the 
affected parts for a considerable length of time. In employing 
liquids to cleanse or medicate the nasal passages always have 
them warmed before using. Never blow the nose violently, as it 
irritates the passages and counteracts, to some extent, the 
curative effects of the Remedy. No harm can result if large 
quantities of the fluid are swallowed, as it contains nothing 
poisonous or injurious. 
902. A belter way. The manner of using Dr. Sage’s 
Catarrh Remedy, advised above, is somewhat imperfect and not 
nearly so thorough a mode as the one to which the reader’s 
attention will now be directed. 
In a very large portion of bad cases of catarrh, or those of 
long standing, the disease has crept along and extended high up 
in the nasal passages and into the various sinuses or cavities and 
tubes communicating therewith. The act of snuffing the fluid 
carries it along the floor of the nose and into the throat, but does 
not carry it high enough, nor fill the passages full enough to 
reach and apply it to all the chambers, tubes and surfaces that 
are affected with the disease. 
The fluid may seem, from the sensation produced, to pass high 
up between the eyes, or even above them, but it does not. It is 
only a sensation transmitted to these parts by nerves, the fila- 
ments of which are distributed to that portion of the mucous 
membrane which the fluid does not reach, just as a sensation is 
transmitted to the little finger by a blow upon the elbow. 
Now, in order to be most successful in curing catarrh, it is neces- 
sary that the remedy should reach and be thoroughly applied to CHRONIC NASAL CATARRH. 
477 
all the affected parts. This can be accomplished in only one 
way,which is by hydrostatic pressure. The anatomy of the nasal 
passages, and the various chambers and tubes that communicate 
therewith, is such that they cannot be reached with fluid admin- 
istered with any kind of a syringe, inhaling tube or instrument, 
except one constructed to apply it upon the principle above 
stated. Such an instrument is the Nasal Douche. 
In using this instrument the fluid is forced into every portion 
of the air passages of the head by its own weight, no snufling 
being required. 
Fig. HO. 
This cut illustrates the manner of using my Nasal Douche. 
903. Directions for using' Dr. Sage’s Catarrh 
Demedy with this Instrument. To cleanse out the 
passages, previous to applying the Catarrh Remedy Fluid, take 
one quart of soft water, add to it two large tablespoonfuls of 
common salt, and shake it up once in a while until all is dis- 
solved. Put the bottle, or reservoir, on a shelf, or hang it up, so 478 
COMMON SENSE MEDICAL ADVISER. 
that it shall be a little higher than the head, fill the reservoir 
with the salt and water, pressing the tube between the thumb 
and finger so as to prevent the fluid from escaping through it; 
introduce the nozzle at the end of the tube into one nostril, 
pressing it in far enough to close the entrance of the passage so 
that no fluid can escape by the side of the tube, breathe through 
the mouth, avoid swallowing, and allow the fluid to flow. The 
soft palate, by the act of breathing through the mouth, is eleva- 
ted so as to completely close the passage into the throat, and 
thus the fluid is made to flow up one nostril in a full, gentle 
stream, pass into and thoroughly cleanse all the sinuses or cavi- 
ties connected with the nasal passages, and flow out of the other 
nostril. 
Do not forget that the instrument will not work properly 
unless you breathe through the mouth and avoid swallowing 
when letting the fluid flow. 
Fill the reservoir a second time with the simple salt and water, 
and inserting the nozzle in the nostril out of which the fluid 
flowed on using it the first time, pass the current through in the 
opposite direction to that in which it was before passed, that is, 
so that it will flow out of the nostril into which it flowed the 
first time of using it. 
After having thus thoroughly cleansed the passages, fill the 
instrument half full or more of the Catarrh Remedy Fluid, 
prepared as heretofore directed, and pass this through the nose 
in the same manner as directed for the salt water. The salt 
water is not curative, but is milder than simple water, and is, 
therefore, preferable for cleansing the passages. All fluids in- 
jected or snuffed into the nose should be warm. 
On first commencing the use of the instrument, it is best to 
hang it only a very little higher than the forehead, but after 
using it a few times, put it up about as high as the length of the 
tube will admit. 
Let no one entertain any feeling of timidity on first com- 
mencing the use of this instrument, as its use is perfectly simple 
and, with the fluids which I recommend, is never attended with 
any strangling, choking pain or other disagreeable sensations, 
but is agreeable and perfectly harmless. The medicine should 
be applied with the Douche at least twice a day, in the morning HAY CATARRH. 
479 
and at night on retiring. There is no advantage in using the 
medicine oftener than three times a day, when used with the 
instrument, but a liberal quantity of the fluid should be used 
each time in order to cleanse all the diseased parts. 
HAY CATARRH. 
904. This affection, known also as Play Asthma, and Hay 
Fever, differs hut little in its manifestations, from coryza, save in 
its inciting cause, and in its element of periodicity. In this lati- 
tude there are a few persons who, between the middle and last 
of August, are invariably attacked with acute inflammation of 
all the air passages, giving rise to sneezing, watery discharges 
from the nose and eyes, difficult respiration, fever, and general 
prostration. These symptoms are supposed to be induced by the 
inhalation of the odor of grasses or flowers, which at that time 
chance to be giving off their most potent exhalations. Unless 
arrested by medical treatment, the disease will last until cool 
weather, or the occurrence of a hard frost shall have rid the 
atmosphere of the irritating perfume. 
Dr. Iflint, a celebrated medical author, says that some feather 
beds give off an odor that excites in him all the aggravated 
symptoms of this disease. He cannot tell before occupying it, 
whether the feathers in a strange bed will be poisonous to him 
or not. But if they are, he will be seized soon after retiring, 
with labored breathing, cough, wheezing and sneezing, until he 
is obliged to get up, when the difficulty will pass off in a few 
hours. This experience is interesting, as it goes to prove that 
certain emanations have the power to incite these inflammatory 
conditions on certain sensitive constitutions. A case or two are on 
record, where the odor from the body of a horse so induced these 
symptoms that the individual could neither ride nor drive him. 
905. Treatment. This disease may be wholly prevented 
by the daily use of Dr. Sage’s Catarrh Remedy, which neutralizes 
and rinses away the odorous particles that poison the mucous 
membrane. The Remedy should, for this purpose, be used with 
my Nasal Injector, or Douche. When the disease already exists, 
and has advanced so that it is accompanied with asthma, my 
Golden Medical Discovery is requisite to cure, and should be 
used in conjunction with the Catarrh Remedy. Two or three 480 
COMMON SENSE MEDICAL ADVISER. 
drops of tincture or fluid extract of lobelia, with the same quan- 
tity of tincture or fluid extract of gelseminum 598), repeated 
three or four times daily, will assist in controlling this very dis- 
agreeable malady. Generally, by a vigorous application of this 
treatment, the patient will soon notice that the disease is yielding 
by degrees, and the improvement will continue until a complete 
cure is effected. 
NASAL POLYPUS. 
906. Nasal Polypi ai*e tumors which grow from the mucous 
membrane of the nasal passages, to which they are generally 
attached by a small pedicle (neck). There are two varieties, the 
gelatinoid and fibroid. The former closely resembles an oyster 
in appearance, color and consistence. This form rarely bleeds. 
The latter is rarer, apter to re-appear, is of a firmer consistence 
and apter to bleed than the former, and is of a deep red or 
purple color. In either variety there is usually more .than one 
present, and they are frequently found in both nostrils. They 
often attain considerable size, and, by pressure upon and displace- 
ment of the surrounding structures, occasion hideous deformity 
of the face. Polypi are very often complicated with nasal 
catarrh, the successful treatment of which necessitates their re- 
moval.. 
907. Causes. Nothing is definitely known regarding their 
causes, but they are generally supposed to originate in some 
constitutional derangement, impairing the nutrition of the mu- 
cous membranes. 
908. Symptoms. These are such as attend stoppage of 
the nose from any cause. There is a sense of obstruction, more 
or less complete, with fullness and weight in one or both nostrils, 
which is increased in damp weather. The voice becomes unnat- 
ural, as when a cold obstructs the nose, and the sleep is fre- 
quently embarrassed by its interference with breathing. The 
nasal discharge is usually increased, and is of a variable character. 
The diagnosis of polypus is not certain without seeing or feeling 
it. By forcing the breath through the nostril in which it is 
supposed to exist, it will generally, if present, come in sight, 
which decides the matter at once. Polypi sometimes grow back- 
ward into the throat, obstructing the posterior openings of the 
nose, where they may be seen or felt. NASAL POLYPUS. 
481 
909. Treatment. Either before or after the removal of 
the tumor, the constitutional derangement must be rectified. 
For this purpose nothing can be better than my Golden Medical 
Discovery. The removal of the polypus may sometimes be 
accomplished by snuffing powdered blood-root. When this fails 
they may be readily removed by any competent surgeon, by 
torsion or the ligature, and the operation is but slightly painful, 
for as no nerves are distributed to these morbid growths, they 
are not sensitive. After their removal the use of Dr. Sage’s 
Catarrh Remedy will prevent their return. 
910. Case I. J. O. N., presented himself in 1872, seeking 
treatment for what he mistook for catarrh. He complained of a 
sense of weight, fullness and obstruction of the nostrils, with dis- 
charge. Examination revealed the existence of polypus, with 
constitutional derangement. 
Treatment. Removed the polypus, advised attention to 
diet, bathing, and recommended the use of my Golden Medical 
Discovery internally, with Dr. Sage’s Catarrh Remedy, to be 
used with my Nasal Douche. No return of the polypus has 
been observed. 
CASES TREATED. 
911. Case II. In July, 1873, a middle-aged gentleman 
from Indiana called at the World’s Dispensary, supposing that 
he was laboring under an aggravated form of catarrh. On ex- 
amination both nasal passages were found to be perfectly filled 
with polypi, which had enlarged until they had pressed the sides 
of the nose out, to such an extent as to produce great deformity, 
giving him a hideous look. The tumors were promptly removed 
by the attending surgeon, proper treatment advised, and I learned 
not long since, through a neighbor of the gentleman operated 
upon, that he has experienced no return of the morbid growths. 
Nasal polypi are so frequently mistaken for chronic catarrh, 
the treatment of which enters so largely into our practice, that 
it has also been our fortune to be consulted very frequently by 
those suffering from the former disease, and the two cases cited 
are but fair samples of a large nixmber on the case books of the 
World’s Dispensary, which have been treated with uniform 
success. 482 
COMMON SENSE MEDICAL ADVISER. 
ACUTE LARYNGITIS. 
912. This is an acute inflammation of the upper portion of 
the windpipe, (see Fig. 43, 73), and is attended with consider- 
able danger. Its causes are colds, suppression of perspiration, 
and such as generally give rise to inflammation (1" 714). 
913. The Symptoms are those common to inflamma- 
tion and follow after a chill. They are soreness or stiffness of 
the throat, difficulty of swallowing and a desire to clear the dis- 
ordered organ. There is fever, the sense of constriction in the 
throat increases, the voice is harsh, hoarse or croaking, and there 
is frequently a hacking cough. The appearance of the throat 
is red and swollen, the voice alters and becomes small, shrill or 
Avhispering and suppressed, and the breathing more difficult. If 
not relieved, delirium or coma come on and the patient dies of 
suffocation. 
914. Treatment, This should be at once prompt and 
thorough, and similar in character to that recommended for in- 
flammations elsewhere, viz: the spirit vapor-bath 630) and hot 
foot-bath 640), to induce sweating, which should be kept up by 
my Compound Extract of Smart-Weed. Diaphoretic infusions 
548), sedatives (*[[ 595), with mucilaginous drinks, and hot 
packs to the throat, are all proper to be employed. The affec- 
tion being very rapid and dangerous, if it does not quickly yield 
to this treatment, no time should be lost in securing skillful 
medical aid. 
CHRONIC LARYNGITIS. 
915. This is of much more frequent occurrence than the acute 
form, and is often associated with tubercular affections 807) 
or constitutional syphilis. It is characterized by an inflammatory 
condition, ulceration or induration (hardening) of the mucous 
membrane of the larynx, most frequently the latter. There 
is also a chronic form known as follicular laryngitis or clergy- 
men's sore throat, to which public speakers are subject. 
916. The Causes of chronic laryngitis are various, as, 
prolonged use of the vocal organs in reading or speaking; using 
them too long on one pitch or key, without regard to their modu- 
lation; improper treatment of acute diseases of the throat; 
neglected nasal catarrh; the inordinate use of mercury; syphilis; CHRONIC LARYNGITIS. 
483 
repeated colds which directly cause sore throat, injuries, etc.: 
it is also frequently associated with tubercular disease, and in 
fatal cases, terminates in consumption. 
917. Symptoms. These often come on insidiously. They 
are, soreness of the throat, noticeable particularly when speaking 
and immediately thereafter; a raw and constricted feeling, lead- 
ing to frequent attempts to clear the throat, in order to relieve 
the uneasy sensation. The voice becomes altered, hoarse and 
husky, and there is a slight, peculiar cough with but little ex- 
pectoration. At first, the matter expectorated is mucus, but as 
the disease advances, and ulceration progresses, it becomes muco- 
purulent, perhaps lumpy, bloody, or is almost wholly pure pus. 
The voice becomes more and more impaired, or is finally lost. 
In the latter stages, it resembles consumption, being attended 
with hectic fever, night-sweats, emaciation, cough, profuse 
expectoration and sometimes hemorrhage. 
918. Treatment. Thorough hygiene should he at once 
instituted, and the patient must refrain from using his voice. 
At the same time, the diet, bathing, clothing, etc., require careful 
attention. Every thing should be done that is calculated to 
build up and improve the general health. My Golden Medical 
Discovery is well calculated to remove morbid states of the 
disease, in consequence of its direct action on the mucous mem- 
branes of the air passages, and its efficacy in allaying irritation 
of the laryngeal, pharyngeal, and pneumogastric nerves (see p. 93, 
Fig. 59). It should be perseveringly employed. Dr. Sage’s 
Catarrh Remedy is of great value in this and kindred affections, 
used as a gargle. There will be experienced, however, some 
difficulty in domestic management, from lack of practical skill, 
in applying it far enough down into the windpipe, and if the 
ulceration has begun, the employment of local measures will be 
necessary; for which purpose, nitrate of silver is generally ad- 
vised by writers. It will be impossible to make the application, 
except the operator is provided with necessary apparatus, and 
is perfectly familiar with the anatomy of the parts; consequently 
I will not take up space by advising treatment which the 
reader himself cannot ordinarily apply. Perseverance is neces- 
sary, and the afflicted are cautioned against discontinuing the 
treatment too soon, or the disease will be very liable to return. 484 
COMMON SENSE MEDICAL ADVISER. 
CASES TREATED. 
919. Case I. A public speaker applied at the World’s 
Dispensary for treatment. He had been a stifferer for years. 
Ilis voice was reduced to a whisper, making an occasional hoarse 
or croaking sound. There was dryness and frequent desire to 
clear the throat; short, frequent, irritating cough, with expecto- 
ration of minute bits of tubercle. There was general debility, 
emaciation and loss of strength. 
Treatment. Instituted perfect hygiene to improve the general 
health. The Golden Medical Discovery was given internally, 
and local applications made to the larynx, where the laryngo- 
scope showed extensive ulceration. In three months he had so 
far improved that local treatment was discontinued, and he re- 
turned home and continued the use of the Discovery for six 
months longer. He was fully restored to health, resumed his 
profession, and two years’ after, remained perfectly well. 
920. Case IS. Rev. Tlios. II. F., consulted me by letter 
in June, 1874, giving his symptoms m detail, which did not dif- 
fer materially from those of the preceding case. 
Treatment. Directed him to take my Golden Medical Dis- 
covery and faithfully follow the hygienic rules heretofore given. 
I also wrote a note to his family physician advising the applica- 
tion of nitrate of silver to the larynx. A letter was received 
from the latter gentleman a few months subsequently, announc- 
ing the patient’s perfect recovery under the course of treatment 
advised. 
CROUP. 
921. Every family should be made acquainted with the symp- 
toms and treatment of this disease. Especially is this true of 
those living remote from a physician. From the lack of this 
knowledge on the part of parents, many a little one has per- 
ished before medical assistance could be obtained. In some of 
its forms its action is very rapid, and, unless relief is obtained in 
a few moments, or hours at the most, death ensues. 
There are several quite distinct pathological conditions of the 
vocal and respiratory organs that have, in popular parlance, been 
designated as croup. But two of these are worthy of consider- 
ation here. These are true or membranous croup, in which a GROUP. 
485 
false, semi-organized membrane is formed, and spasmodic croup. 
Both are liable to result in death. True croup is supposed to 
originate in the trachea (windpipe), from which, as it progresses, 
it often extends upward to the larynx and downward to the 
bronchial tubes. It is the result of severe inflammation of the 
mucous membrane, and is characterized by the formation of a 
false membrane, which covers or lines the inner surface of the 
true structure (see Fig. 150). But whence 
does this film arise ? It is formed of a coag- 
ulable semi-fluid exudation from the mucous 
membrane itself. On being brought to the 
surface and into contact with the inspired air, 
this substance grows thick and tough, or 
leathery, as we find it. It is the obstruction 
of the respiratory canal with this foreign 
matter, that causes the labored breathing, 
and the ringing, brassy cough, together with 
the crowing or whistling inspiration, charac- 
teristic of croup. Before recovery can take 
place it must be detached and expelled. The 
cough is nature’s effort to accomplish this 
work. But her effort is apt to prove fruit- 
less unless the invader’s hold is loosened by 
suppuration. 
The formation of this adventitious mem- 
brane in the lai-ynx is attended with more 
danger than when it is confined to the 
ti-achea. In most cases where the disease has had a very speedy 
fatal termination, an examination has shown that the larynx was 
its chief seat. 
Fig. 150. 
False Membrane in 
Croup. From a speci- 
men in Dr. Gross’ cabi- 
net. 
922. Symptoms. True croup is generally preceded by 
what is popularly called “ a cold.” The child coughs, sneezes and 
is hoarse. It is the hoarseness and the peculiar character of the 
cough that indicates the croupy tendency. This has been already 
described. In addition, the child is restless, fretful and feverish. 
The disease makes rapid stiides. Finally the cough ceases to be 
loud and barking, and is very much suppressed; the voice is almost 
gone; the face is very pale; the head thrown back; the nostrils 
dilated and in perpetual motion, pulse at the wrist very feeble, 486 
COMMON SENSE MEDICAL ADVISER. 
great exhaustion, more or less delirium and soon death comes to 
the relief of the little sufferer. Convulsions sometimes occur 
and soon terminate fatally. 
923. Treatment. No time should he lost in commenc- 
ing treatment. Hot fomentations (®f 649) should be applied to 
the throat and upper portion of the chest. The free administra- 
tion of lobelia 573) in form of infusion, to produce free vomit- 
ing, will produce a salutary effect if employed early, before the 
false membrane has commenced to form, but will not be proper 
after the early stage is passed. The agent which I have found 
to manifest the most specific and remedial effect on this disease, 
is an acetic syrup of blood-root (•[ 465) made by adding one tea- 
spoonful of the crushed or powdered root to one gill of vinegar 
and four tablespoonfuls of white sugar. Heat this mixture to 
the boiling point, strain, and administer while warm, from one- 
fourth to one teaspoonful every half hour or hour, regulating the 
interval between doses by the urgency of the case. It should 
be given sufficiently often to keep up slight nausea, but not so 
as to produce vomiting. The patient’s body should be frequently 
sponged with hot water in which a sufficient quantity of salaera- 
tus or ordinary baking soda has been dissolved to render it quite 
strongly alkaline. The tincture or fluid extract of veratrum 
597) should be administered to control the inflammation. 
Five drops to twenty teaspoonfuls of water, of which a teaspoon- 
ful may be given every hour, will be about the proper dose for a 
child one year old. The bowels should be moved. My Pleasant 
Purgative Pellets will be found to meet this indication admir- 
ably. If not able to give them whole, in their sugar-coated 
form, one or two may be broken up and mixed with a little sugar 
or sauce of some kind, or with water, and thus administered. 
Tonics, as quinine (1" 496), or hydrastin 613), or one of these 
with some form of iron 618), may advantageously be given 
three or four times a day, should the disease appear to be ex- 
hausting the strength, as it will if continued long. Beef tea 
(*[ 666) and other concentrated supporting diet, should be freely 
administered. The treatment which I have advised has been put 
to the severest tests in the most malignant forms of the disease, 
and has resulted most successfully. If, however, in any case 
it does not give prompt relief, my advice is to lose no time CONSUMPTION. 
487 
in summoning a physician who is known to be skilled in the 
treatment of diseases of children. 
924. Spasmodic Croup. In this affection no false 
membrane is formed. It seems to have a nervous origin. Most 
frequently the child is awakened in the night by a sense of suf- 
focation. He may cry out that he is choking. The countenance is 
livid, the breathing is hurried and each respiration is attended by 
a crowing sound. The child has fits of coughing or crying and 
makes vehement struggles to recover his breath. This complaint, 
unlike true croup, is unattended by fever, it being of a purely 
spasmodic character with no inflammation. 
925. Treatment. This is simple, easily applied and 
gives prompt relief. Apply hot fomentations to the throat, and 
give frequent small doses of tincture, or fluid extract, or syrup of 
lobelia 573), to produce slight nausea; the specific antispas- 
modic effects of this agent are all that is required. 
926. By this we understand a constitutional affection, char- 
acterized by a wasting away of the body, attended by the 
deposition of tubercular matter into the lung tissue. Hence the 
appellations, Phthisis Pulmonalis; Pulmonarg Tubercolosis; 
Tubercular Consumption. Tubercles may form in other organs 
and result in a breaking down of their tissues, but the employ- 
ment of the term “ consumption ” in this article is restricted to 
the lungs. The general prevalence, the insidious attack and the 
distressing fatality of this disease, demand the special attention 
and investigation of every thinking person. It preys upon all 
classes of society. Rich and poor alike furnish its victims. 
Some idea of its prevalence may be formed when we consider 
that, of the entire population of the globe, one in every three 
hundred and twenty-three persons, annually dies of consump- 
tion. It may not be definitely known just what proportion of 
all the deaths in this country and Europe occurs from this one 
disease. Those who have gathered statistics differ somewhat, 
some claiming one-fourth, while others put the ratio at one- 
sixth, one-seventh and even as low as one-ninth. A fair estimate, 
and one probably very near the truth, would be one-sixth or 
one-seventh of the whole number. In New York City, for five 
CONSUMPTION. (Phthisis Pulmonalis.) 488 
COMMON SENSE MEDICAL ADVISEE. 
consecutive years, the proportion was three in twenty. In New 
England, about twenty thousand annually succumb to this 
destroyer, and in the State of New York as many more. These 
figures may appear to be exaggerations, but investigations of the 
subject prove them to be the simple truth. Epidemics of 
cholera, yellow fever, and other diseases of similar character, so 
terrible in their results, occasion wide-spread alarm, and receive 
the most careful considerations for their prevention and cure, 
while consumption receives scarce a thought. Yet the number 
of their victims sinks into insignificance when compared with 
those of consumption. Like the thief in the night, it steals 
upon its victim unawares. In a large proportion of cases, its ap- 
proach is so insidious, that the early symptoms are almost wholly 
disregarded; indeed they excite but little, if any attention, 
and perhaps for a time disappear altogether. Thus the patient’s 
suspicions, if they have been aroused, are allayed and appro- 
priate measures for his welfare are discontinued. This may be 
the case until renewed attacks firmly establish the disease, and 
before the patient is fully aware of the fatal tendency of his 
malady, he is progressing rapidly towards that “bourne from 
whence no traveler returns.” 
927. As has already been stated, consumption is a constitu- 
tional disease, manifested by feeble vitality, loss of strength, 
emaciation—symptoms which too often are classed under the 
name of “ general debility,” until local symptoms develop, as 
cough, difficult breathing, or hemorrhage, when examination of 
the chest reveals the startling fact that tubercles have been 
formed in the lungs. Invalids are seldom willing to believe that 
they have consumption, until it is so far advanced that all medi- 
cine can possibly do is to smooth the pathway to the grave. 
Another characteristic of this disease is remains 
active until the very last, flattering the patient into expectation 
of recovery. To the influence of this emotion, the prolongation 
of the patient’s life may often be attributed. 
928. Nature of the Disease. It is. an error to sup- 
pose that the disease under consideration is confined to the lungs. 
“ Pulmonary Consumption,” as Dr. Latham remarks,' “ is but a 
fragment of a great constitutional malady.” The., lungs are 
merely the stage where it plays its most conspicuous part. A CONSUMPTION'. 
489 
“ peep behind the curtain,” showing the preliminary processes of 
the melancholy exhibition, would prove that every part of the 
system is more or less involved, every vital operation more or 
less deranged; especially would the nutritive function be found 
to be vitiated and imperfect. The secretive and exci*etive opera- 
tions would not be blameless, neither could the nerve forces plead 
“ not guilty.” The circulation would also be involved in the 
general morbid condition. Tubercles, which constitute a marked 
feature of the disease, are composed of unorganized matter 
deposited from the blood into the tissues of the lungs. They are 
small globules of a yellow, opaque, friable substance, of about 
the consistency of cheese. After their deposition, they are in- 
creased in size by the accretion of fresh matter of the same kind. 
They are characteristic of all forms of scrofulous disease. (See 
article on Scrofula, page 434). 
The most plausible theory in regard to them is, that they are 
the result of imperfect nutrition. Such a substance cannot be 
produced in the blood, when the blood is perfectly formed. It is 
an unorganized particle of matter, resulting from the imperfect 
elaboration of the products of digestion, which is not therefore 
properly fitted for assimilation to the tissues. The system being 
unable to appropriate it, and powerless to cast it off through the 
excretory channels, deposits it in the lungs or other parts of the 
body. There it remains as a foreign substance—in the body but 
not of it—like a sliver or thorn in the flesh, until ejected by 
suppuration and sloughing of the surrounding parts. It might 
be supposed by some that when the offending matter was thus 
eliminated from the lungs, they would heal and the patient 
recover. But, unfortunately, the deposition of tuberculous mat- 
ter does not cease. Owing to the morbid action of the vital 
forces, it is formed and deposited as fast or faster than it can be 
thrown off by expectoration. Hence arises the remarkable 
fatality of Pulmonary Consumption. 
929. Causes. The causes of consumption are numerous 
and varied, hut may all he classed under two heads, viz: Constitu- 
tional or predisposing and local or excitmg. Of just what 
tubercular matter consists is still a subject of controversy; but 
that its existence depends upon certain conditions, either con- 
genital or acquired, is generally conceded; and one of these 490 
COMMON SENSE MEDICAL ADVISER. 
conditions is impaired vitality. Constitutional predisposition must 
first give rise to conditions which will admit of the formation of 
tubercular matter, before any cause whatever can occasion its 
local deposition. It must first modify the vitality of the whole 
system, when other causes may determine in the system thus 
impaired, the peculiar morbid action of which tubercle is the 
product. The general division of causes into predisposing and 
exciting must ever be more or less arbitrary. Individuals sub- 
ject to predisposing causes may live the natural term of life and 
finally die of other disease. Indeed, when predisposing causes 
are known to exist they should constitute a warning for the 
avoidance of other causes. Again, among the so-called exciting 
causes, some may operate in such a manner,with some individuals, 
as to predispose them to consumption, and the results will be the 
same as if the predisposition had been congenital. The causes 
that in one individual are exciting, under other cii’cumstances 
and in other individuals would be predisposing, because they act 
so as to depress the vitality and impair the nutritive processes. 
930. The Predisposing Causes, then, are, heredi- 
tary predisposition, scrofula, incompatibility of temperaments 
in parents, sexual exhaustion of parents, excessive sexual indul- 
gence during pregnancy, climatic influences, sedentary habits, 
depressing emotions, in fact, any thing that impairs the vital 
forces and interferes with the perfect elaboration of nutritive 
material. 
931. The Exciting Causes are those capable of arous- 
ing the predisposing ones into activity, and which, in some 
instances, may themselves induce predisposition; as, spermator- 
rhoea, dyspepsia, nasal catarrh, colds, suppressed menstruation, 
bronchitis, syphilis, retrocession of cutaneous affections, measles, 
scarlatina, malaria, whooping-cough, small-pox, protracted 
fevers, pleurisy, pneumonia, long-continued influence of cold, 
sudden suspension of long-continued discharges, masturbation, 
excessive venery, wastes from excessive mental activity 226), 
insufficient diet, both as regards quantity and quality, exposure 
to impure air, atmospheric vicissitudes, damp, dark dwellings, 
dampness, with the absence of light 329), prolonged lactation, 
depressing mental emotions, insufficient clothing, improper treat- 
ment of other diseases, exhaustive discharges, tight lacing, fast CONSUMPTION. 
491 
life in fashionable society, impurity and impoverishment of the 
blood from any cause, etc. Indeed this list might be greatly 
extended, but the other causes, which have an influence, are 
generally in some manner allied to those already named. 
932. Symptoms. The symptoms of consumption vary 
with the progress of the disease. Writers generally recognize 
three stages, which so gradually change from one to the other 
that a dividing line cannot be drawn. As the disease progresses 
new conditions develop, which are manifested by new symptoms. 
Prior to the advent of pulmonary symptoms is the latent period, 
which may extend over a variable length of time, from a few 
months to several years; and indeed, may never be developed 
any farther. Until sufficient tubercles have been formed in the 
lungs, to alter the sounds observed on auscultation 683) and 
percussion 684), an unequivocal diagnosis of tubercular con- 
sumption cannot be made, even though there may have been 
hemorrhage, which seldom occurs in any other disease. Never- 
theless, when we find paleness, emaciation, accelerated and diffi- 
cult breathing, increased frequency of the pulse and general de- 
bility, coming on gradually without any apparent cause, we have 
sufficient grounds for grave suspicions. This is increased if ten- 
derness under the collar-bone, with slight hacking cough is 
present, and the spirometer 685) shows diminished breathing 
capacity. These symptoms should be sufficient to warn any in- 
dividual who has the slightest reason to believe that he is disposed 
to consumption, to lose no time in instituting the appropriate 
hygienic and medical treatment, for it is now that remedies will 
be found most effective. Unfortunately this stage is too apt 
to pass unheeded, or receive but trifling attention; the patient 
finds some trivial excuse for his present condition, and believes 
that he will soon be well. But, alas for his anticipations! The 
disease goes onward and onward, gradually gaining ground, from 
which it will be with great difficulty dislodged. 
The cough now becomes sufficiently harassing to attract atten- 
tion, and is generally worse in the morning. The expectoration 
is slight and frothy; the pulse varying from ninety to one hun- 
dred and twenty in a minute and sometimes even higher. 
Flushes of heat and burning of the soles of the feet and palms 
of the hands are experienced. A circumscribed redness of one or 492 
COMMON SENSE MEDICAL ADVISER. 
both cheeks is apparent. These symptoms increase in the after- 
noon, and in the evening are followed by a sense of chilliness 
more or less severe. The appetite may be good, even voracious; 
but the patient remarks that his food “ does not seem to do him 
any good,” and to use a popular expression, “ he is going into a 
decline.” As the strength wanes the cough becomes more and 
more severe, as if occasioned by a fresh cold in which way the 
patient vainly tries to account for it. Expectoration increases, 
becomes more opaque, and perhaps yellow, with occasionally 
slight dots or streaks of blood. The fever increases, and there is 
more pain and oppression in the chest, particularly during deep 
respiration after exercise. Palpitation is more severe. Perhaps 
there may now be night-sweats — the patient waking in the 
morning to find himself drenched in perspiration, exhausted and 
haggard. Bleeding from the lungs occurs, and creates alarm 
and astonishment, often coming on suddenly without warning. 
The hemorrhage usually ceases spontaneously, or on the admin- 
istration of proper remedies, and in a few days the patient feels 
better than he has done for some time previous. The cough is 
less severe, and the breathing less difficult. Indeed, a complete 
remission sometimes occurs, and both patient and friends deceive 
themselves with the belief that he is getting well. 
After an indefinite length of time, the symptoms return with 
greater severity. These remissions and aggravations may he 
repeated several times, each successive remission being less per- 
fect, each recurrence more severe, carrying the patient further 
down the road toward the “dark valley.” Now the cough 
increases, the paroxysms become more severe, the expectoration 
more copious and purulent (mattery), as the tubercles soften and 
break down, and it sometimes sinks in water. The voice is hollow 
and reverberating; the chest is flattened, and loses its mobility; 
the collar-bones are prominent, with marked depressions above 
and below. Auscultation reveals a bubbling, gurgling sound, as 
the air passes through the matter in the bronchi, with a click to 
the air cells beyond. Percussion gives a dull sound, wdiich 
diminishes from above downwards; or if there are large cavern- 
ous excavations, it is hollow, and auscultation elicits the amphoric 
sound, as of blowing into a bottle. Hectic fever is now fully 
established; the eye unusually bright and pearly, with dilated CONSUMPTION. 
493 
pupils, which give a peculiar expression; the paroxysms of cough- 
ing exhaust the patient, and he gasps and pants for breath. The 
tongue now becomes furred, the patient thii'sty, the bowels con- 
stipated, and all the functions are irregularly performed. Another 
remission may now occur, and the patient be able to resume light 
employment and cares, for an indefinite length of time, which I 
have known to extend over three or four years, when the symp- 
toms again return. 
933. If the patient is a female, and deranged or suppressed 
menstruation did not mark the accession of pulmonary symptoms, 
it now becomes profuse and clotty, or is scanty and colorless, 
and sometimes ceases altogether. In the male, the sexual powers 
diminish, and copulation is followed by excessive and long-con- 
tinued prostration. From this time onward, the progress of the 
disease is more rapid. The liver and kidneys are implicated. In 
addition to the pallor, the complexion becomes jaundiced, giving 
the patient,who is now wasted to a mere skeleton, a ghastly look. 
The urine is generally copious and limpid, though occasionally, 
scanty and yellow. The pulse increases to one hundred and 
thirty or one hundred and forty in the minute, and is feeble and 
threadlike. The cough harasses the patient so that he does not 
sleep, or his rest is fitful and unrefreshing; whenever sleep does 
occur, the patient wakes to find himself drenched with a cold, 
clammy perspiration. The throat, mouth, and tongue, now be- 
come tender, and occasionally ulcerate. Expectoration is profuse, 
purulent, and viscid, clinging tenaciously to the throat and mouth, 
and the patient no longer has strength to eject it. The hair now 
falls off, the nails become livid, and the breathing difficult and 
gasping; the patient has no longer strength to move himself in 
bed and has to be propped up with pillows, and suffocates on as- 
suming the recumbent position. Drinks are swallowed with diffi- 
culty. Diarrhoea takes the place of constipation. The extremities 
are cold, swollen and dropsical; the voice feeble hollow, grating, 
husky, the patient gasping between each word. The breath is 
short and quick. A slight remission of these symptoms occurs. 
The patient is more comfortable, lively, cheerful, and perhaps 
plans for the future. But it is the last effort of expiring vitality 
—the last flicker of the lamp of life—the candle burns brilliantly 
for a moment, and with one last effort goes out, and death closes 
the scene. 494 
COMMON SENSE MEDICAL ADVISER. 
934. The duration of the active stage of consumption varies 
from a few weeks to several years, the average time being 
about eighteen months. 
Gougli is always a prominent symptom throughout the entire 
course of the disease, varying with its progress. 
Expectoration, at first scanty, then slightly increased, colorless, 
frothy and mucous,is also a prominent characteristic. After a time 
it becomes opaque, yellow and more or less watery; then muco- 
purulent (mucous and mattery) and finally purulent, copious 
and viscid. When tubercular matter is freely expectorated,with 
but little mucus, it sinks in water. This symptom continues to 
the very last. 
Hemoptysis (bleeding from the lungs) may occur at any stage 
of the disease, often being the first pulmonary symptom noticed, 
again being delayed until late; and there are cases in which it 
does not happen at all. It seldom occurs in any other disease. 
Night-sweats may occur at any stage, though they are rarely 
experienced until the disease is pretty well established, and are 
very exhaustive. 
Hectic Fever generally occurs soon after the pulmonary 
symptoms are developed, and increases in intensity with the pro- 
gress of the disease. There are usually two paroxysms in the 
twenty-four hours, one of which occurs towards evening and is 
followed by the night-sweats. 
Pyspncea (difficult breathing) is at first slight, except after 
exertion, amounting to only a sense of oppression; but it becomes 
more and more severe as the disease advances, until the very last, 
wrhen it is agonizing in the extreme. 
Apthoe (ulceration of the mouth) sometimes extending to the 
pharynx and larynx, generally occurs towards the last. The mouth 
and throat become so very soi*e and tender, that nourishment and 
medicine are taken with difficulty. 
Emaciation and Debility are characteristic of the disease. 
They fluctuate — as the disease advances or is retarded, but be- 
come gradually more and more marked, increasing to the very 
last. 
935. Auscultation and Percussion (1 683, 684) constitute 
valuable means of diagnosis, from the time tubercles begin to be 
deposited to the very last, and when correctly practiced, reveal CONSUMPTION. 
495 
the extent and progress of the disease. As a knowledge of the 
sounds elicited can only be acquired by practical experience with 
proper instruments, they will not be explained here. The only 
diseases with which consumption is likely to be confounded, is 
general debility in the early stage, bronchitis, chronic pleurisy, 
chronic pneumonia, and pulmonary abscess after the advent of 
pulmonary symptoms. 
936. Curability. Notwithstanding the prevalence of an 
opinion that consumption is incurable, there exists ample, incon- 
trovertible evidence to the contrary. Its curability is established 
beyond the shadow of a doubt. Individuals have recovered 
where extensive destruction of pulmonary tissue existed; indeed 
they have recovered with but one lung. Numerous instances are 
on record where persons have suffered with all the symptoms of 
confirmed consumption, and have regained their health and sub- 
sequently died of other diseases. The case of the late Dr. 
Joseph Parish, of Philadelphia, alfords a striking example of 
this kind. In his early life he manifested all the symptoms of 
confirmed consumption, including frequent hemorrhages, yet he 
perfectly regained his health, and, after a very useful life, died 
at an advanced age of another disease. Post-mortem examination 
revealed the existence of cicatrices (scars) in his lungs where 
tubercles had been deposited. Dr. Wood, in his Practice of 
Medicine, mentions another instance of a medical gentleman in 
Philadelphia, who in early life suffered from consumption with 
hemoptysis, from which he recovered, and afterwards died at an 
advanced age, of typhoid fever, when the knife revealed the 
presence of cicatrices. Post-mortem examinations of individuals 
that have died of other diseases, have revealed, in numerous instan- 
ces, the existence of consumption at some time of life. In these 
cases the lungs were perfectly healed by cicatrization, or by the 
deposit of a chalky material. A French physician made post- 
mortems of one hundred women, all above sixty years of age, 
who died of other diseases, in fifty of whom he found evidence 
of the previous existence of consumption. 
Professor Flint, who has enjoyed opportunities for extensive 
observation in both hospital and private practice, says that 
consumption sometimes terminates in recovery, and that his 
observations lead him to the conclusion that the prospect of 496 
COMMON SENSE MEDICAL ADVISER. 
recovery is more favorable in cases characterized by frequent 
hemorrhages. Drs. Ware and Walshe are also led to the same 
conclusion. 
Professor J. Hughes Bennett, of Scotland, has thoroughly 
investigated the subject, and adds his testimony to that of 
others, and cites numerous cases that have recovered perfectly. 
If such testimony is not sufficient, I may mention the following, 
whose names are well known and respected in professional 
circles, and all of whom declare that consumption is a curable 
disease. The list includes Laennec, Andral, Cruveilheir, Kingston, 
Presat, Rogee, Boudet and a host of others. 
No farther back than 1866, on page 145, of the proceedings of 
the Connecticut Medical Society, we find “ observations Ante- 
mortem and Post-mortem, upon the case of the late President 
Day, by Prof. S. G. Hubbard, M. D., New Haven,” from which 
we learn that Jeremiah Day, LL. D., who wTas for twenty-nine 
years President of Yale College, was, while a mere youth, a vic- 
tim to pulmonary consumption. During his infancy and boyhood 
his vitality was feeble. He entered Yale College as a student in 
1789, “but,” as Prof. Hubbard remarks, “was soon obliged to 
leave college on account of pulmonary difficulty, which was 
doubtless the incipient stage of the organic disease of the lungs 
wdiich subsequently developed itself.” lie remained in feeble 
health for two years, but returned to college and graduated in 
1797. For the next six years his lung difficulties were quite 
severe, and he repeatedly bled from the lungs in large quantities, 
but he had so far recovered in 1803, as to accept a Professorship. 
He was afterward chosen President of the college, which office he 
held for many years in the enjoyment of good health. He died 
from “old age,” as we are told, in 1867, aged 94 years ! 
937. Statistics claim, that ‘ under the improved methods of 
treating this disease, the mortality, as compared -with previous 
years, has been considerably reduced. Clinical observation 
proves that injuries to the lungs are not so fatal as was once 
supposed. 
938. Treatment. The earlier the treatment of this dis- 
ease is undertaken, the greater will he the probability of success. 
The reason of this is obvious; at first the disease is general or 
constitutional, but as it advances, by the formation of tubercles, CONSUMPTION. 
497 
it becomes both constitutional and local. Hence the treatment 
must be both general and special. The occurrence of certain 
prominent and distressing symptoms, either from the natural 
progress of the disease, or from complications with other affec- 
tions, often renders it difficult, even for physicians, to determine 
how far their treatment shall be general and how far special. 
939. Treating the symptoms instead of the general disease, 
or treating the constitutional disease without regard to the symp- 
toms which arise from it, are errors into which many physicians 
have fallen. The constitutional affection, the local manifesta- 
tions and complications, and the circumstances and individual 
peculiarities of the patient, must all be carefully considered; 
remembering all the while, that tubercle is the product of a 
morbid action, which, in every case, must exist before its depo- 
sition in the lungs or any other tissue can take place. 
940. In every case where curative treatment is to be instituted* 
the hearty and persistent co-operation of both patient and friends 
is absolutely necessary; and the treatment, which is both hy- 
gienic and medical in character, must be based upon the following 
indications: 
(1.) The avoidance of the causes concerned in the production 
and perpetuation of the disease. 
(2.) The restoration of healthy nutrition, in order to stop the 
formation of tuberculous matter. 
(3.) The arrest of the abnormal breaking down of the 
tissues, which, with improved nutrition, prevents emaciation. 
(4.) The relief of local symptoms, and the complications 
arising from other disease. 
941. To fulfill the first indication, the avoidance of causes, 
is of the utmost importance, for if they have origiluilly been 
sufficient to produce the disease, their continued operation must 
certainly be sufficient to perpetuate it. A single individual is 
very often subjected to the operation of several of; the causes 
already enumerated, some of which, in consequence of his circum- 
stances and surroundings, are unavoidable. Of these,;the one 
most difficult to overcome is climate; i. e. the frequent variations 
of temperature, or the sudden changes from heat to cold. 
942. Upon the subject of climate much has been written. 
But the one best adapted to the cure of consumption, is the one 498 
COMMON SENSE MEDICAL ADVISEE. 
that will enable the patient to pass a certain number of hours 
each day in the pure open air, without exposure to sudden 
variations of temperature. There are very few persons who 
change their residence, except as a last resort, when the disease 
is in the latter stage. It is then productive of little or no good. 
This is one reason why so many people having consumption die 
in Florida, and other warm countries. If a change of climate 
is to be effected at all, it should be done early. 
943. The best directions for general application, to enable 
one to avoid causes, is to carry into effect the best possible hy- 
gienic regulations for the maintenance of a perfect standard of 
health. For this purpose the reader is referred to that part of 
this work treating of Hygiene, which he should carefully study, 
as well as the relations between proper hygiene and the causes of 
disease operating in his individual case. 
944. The strongest stimulant to health is well regulated exer- 
cise. It assists the performance of every function and is of 
paramount importance to good digestion and proper assimilation 
— conditions essential to recovery. It should not, however, be 
carried beyond the powers of endurance of the individual, so as 
to exhaust or fatigue. Everything that can invigorate should be 
adopted; everything that exhausts should be shunned. 
945. To fulfill the second indication—to restore healthy nutri- 
tion—requires not only a proper diet, both as regards quantity and 
quality, but demands that the integrity of the organs concerned 
in the process of digestion and assimilation, shall be elevated, and 
maintained at the highest standard of perfection possible. 
The necessity that the diet be sufficient in quantity must be 
obvious to all. It is also necessary that it be nutritious and that 
it should fontain carbonaceous elements, to keep up the animal 
heat. Food of a starchy or saccharine character is apt to increase 
acidity and interfere with the assimilation of other elements. The 
albuminous and oily foods have an opposite tendency— alkalinity 
— and are favorable to nutrition. The articles of diet best adap- 
ted to the consumptive invalid are eggs, bread made from 
unbolted wheat flour, cracked wheat, oatmeal, milk, rich cream, 
good butter, beef, game, fowls, etc. These contain the necessary 
elements for assimilation. Oily food is of great importance, and 
the beef eaten should contain a good proportion of fat. Cream CONSUMPTION. 
499 
and good butter are excellent, far surpassing cod-liver oil in their 
beneficial effects; they are much more palatable and should be 
eaten largely. Plenty of salt should always be eaten with the 
food, and a desire for it is often experienced. It fills certain indi- 
cations admirably by its decomposition into soda and muriatic 
acid, the former increasing alkalinity of the blood, and the latter 
improving both the quantity and quality of the gastric juice. 
Over-eating should be avoided, lest the stomach be induced to 
rebel against articles of diet, rich in important elements. See 
article on diet. 
946. Derangement of the process of nutrition requires careful 
attention and mal-assimilation must be corrected. For this pur- 
pose nothing can excel my Golden Medical Discovery. It 
increases the appetite, favors the nutritive transformation of the 
food, enriches the blood and thus retards the development of 
tubercles. It is so combined that, while it meets all these 
indications, it relieves or prevents the development of those 
distressing symptoms so common in this disease. 
By reference to 620, it will be seen how perfectly my 
Golden Medical Discovery is adapted to fulfill the third indica- 
tion in arresting and curing this disease—which is to check the 
abnormal breaking down and waste of tissues that constitutes 
such a prominent feature in this malady. The antiseptic proper- 
ties of the Discovery are unmistakably manifested in preventing 
such abnormal decomposition. The emaciation, excessive expec- 
toration, profuse perspiration, diarrhoea and hectic fever, common 
to consumption, are all due to a too active disintegration and 
Avaste of the tissues. It is in this condition of the system that 
my Discovery, by its powerful antiseptic properties, mani- 
fests its most wonderful curative ability. When, as in this 
disease, the vital forces of the system have, in a degree, lost 
their restraining influence over the processes of disintegration, 
waste and decay, which go on so rapidly that nutrition cannot 
compensate for the loss to the system, then it is that my 
Discovery, by its antiseptic influence, checks this melting up of 
the tissues by the chemical forces of the body, and thus arrests 
the disease. I shall never forget my delight on first witnessing 
its magic power over this heretofore uncontrollable condition of 
the system. To the lack of such an element in the treatment of 500 
COMMON SENSE MEDICAL ADVISER. 
consumption the unparalleled fatality of the disease is largely 
due. In their anxiety to improve digestion and nutrition, and 
thus build up the tissues, physicians lose sight of the no less 
important indication of restraining the destructive waste going 
on in the system which overbalances the supplies furnished by 
digestion. The gradually increasing emaciation and loss of 
strength renders perpetuity of the organism impossible. 
947. The fulfillment of the fourth indication—to relieve local 
symptoms, and the complications with other diseases—is often 
attended with no little difficulty. 
948. The Cough is a secondary symptom, arising from the 
irritation caused by the tubercles. The attempt to cure it by 
means of medicated inhalations cannot but be attended with 
failure. They may palliate, and relieve irritability of the lungs, 
but, from the nature of the disease, they cannot cure it. They 
strike at the branches of the disease, while the root is left to 
flourish, to develop new branches, and replenish the old. 
Expectorants have been employed to a great extent, and the 
theories that have been advancec] advocating their use are some- 
times very ingenious. That they modify the cough, we do 
not attempt to deny; but it is at a terrible expense, for they 
derange the stomach and interfere with digestion and assimila- 
tion—they modify a single symptom, and intensify the real 
disease. 
A new theoiy has been recently advanced to favor the sale of 
expectorant medicines, viz: that they “ripen the matter in the 
lungs,” “ rot away,” and thus favor the expulsion of the tuber- 
culous deposits. But while they are “ rotting away ” tubercles, 
they destroy the sound tissue also, and do not in the least arrest 
the formation of more tubercles. * 
949. Improvement of the general health will always he at- 
tended with amelioration of the cough. If the patient did not 
cough at all, the lungs would soon fill up with v broken-down 
tissue, and death from suffocation result. Irritation of the nerves 
supplying the lungs sometimes occurs, and causes' the patient to 
cough immoderately, when it is not necessary for the purpose of 
expectoration. This condition is readily controlled by the Gol- 
den Medical Discovery, which exerts a decidedly quieting and 
tonic influence upon the pneumogastric nerve, which, with its CONSUMPTION. 
501 
ramifications, is the one involved. An infusion of the common 
red clover, in tablespoonful doses, will also be found a valuable 
adjunct in overcoming this condition. 
950. Hemoptysis. Hemorrhage from the lungs is generally 
sudden and unexpected in its attack, though sometimes preceded 
by difficulty of breathing, and a salty taste. Although it very 
rarely destroys life, it occasions intense alarm. Common table- 
salt, given in one-fourth to one-half teaspoonful doses, repeated 
every ten or fifteen minutes, is generally sufficient to control it. 
Ligatxires applied to the thighs and arms, sufficiently tight to 
arrest the circulation of blood in the veins, but not tight enough 
to impede i1r in the arteries, is a useful proceeding. Hamamelis 
(1” 518), erigeron 522), gallic acid 524), and lycopus 521), 
are all valuable for this purpose. 
951. Night-sweats can only be regarded as a symptom of 
weakness, and are to be remedied by an improvement of the 
general health. Bathing in salt water is sometimes attended 
with good results. The practice of giving acids for this symp- 
tom can only be regarded as irrational. It may arrest the 
sweating, but it will increase the acidity of the system and inter- 
fere with the assimilation of oleaginous matter. 
952. Frequency of the Pulse is generally a prominent symp- 
tom in this disease. It points to a condition of sufficient import- 
ance to require a remedy. Although the Discovery is combined 
to meet this condition, its value may be greatly enhanced by 
adding one-half to one teaspoonful (according to the urgency of 
the case and the frequency of the pulse) of the fluid extract of 
veratrum 597) to each bottle. The benefit of this when 
persisted in, will be apparent in the amelioi-ation of all the 
symptoms, and in the general improvement. 
953. Diarrhoea is sometimes a troublesome symptom, and 
particularly so in the latter stages of the disease. It is generally 
due to acidity of the alimentary canal, to which the treatment 
must be directed. Greater care must be had in the selection of 
the diet, improving the quality and avoiding everything which 
disagrees with the patient. Improve digestion by every possible 
means. Carbonate of soda and rhubarb, in form of syrup, is 
sometimes excellent. My Compound Extract of Smart-Weed 
will generally, in small doses, arrest the too frequent discharges. 502 
COMMON SENSE MEDICAL ADVISER. 
954. Derangement of the Liver is often a complication de- 
manding attention, and one which, when relieved, goes very far 
in ameliorating the general condition of the patient. The Golden 
Medical Discovery is generally sufficient for the relief of this 
symptom. Its influence, however, may be considerably increased 
in this direction by the use of my Pleasant Purgative Pellets, 
according to the directions which accompany them. 
955. Uterine Derangements. In the female, derangement of 
the menstrual function is generally an early complication of con- 
sumption, if indeed it does not occur at the outset. It deserves 
early attention, and in addition to the remedies already advised, 
my Favorite Prescription is so combined as to meet the require- 
ments of this condition, and at the same time exert a favorable 
influence upon the constitutional disease. 
CASES TEEATED, 
956. Case I. John W., aged 28, applied at the World’s 
Dispensary in March, 1873. Had been subject to poor health for 
several years, during which time his mother and only sister had 
died of consumption. Appetite poor, considerable emaciation, 
debility, quick pulse, subject to “frequent colds,” consider- 
able cough and expectoration, with difficulty of breathing, and on 
exercise, palpitation. Spirometer showed diminished breathing 
capacity. Upon auscultation the respiratory sounds were indis- 
tinct, with more or less mucous sounds, and percussion revealed 
dullness of sound under the collar-bones. Diagnosis. — First 
stage of pulmonary consumption. 
Treatment. Advised outdoor exercise, remaining out as much 
as possible, taking care to protect himself from the vicissitudes 
of the weather,wearing plenty of flannel clothing next to the skin, 
and regular bathing. A diet of eggs, milk, cream, beef, wheat 
bread, etc., was ordered. To each bottle of Discovery I added a 
drachm of fluid extract of veratrum, and of this mixture he took a 
teaspoonful every three hours during the day and evening. In 
two months he wrote, stating that he was improving. Advised 
him to continue the same treatment. He continued to improve 
and at the end of four months wrote as follows: “ I am feeling 
better than I have for ten years; have gained strength and flesh, 
and can do a day’s work. I consider myself well. I think my CONSUMPTION. 
disease is permanently arrested, and I shall endeavor to profit by 
your advice, and change to a more propitious climate, to prevent 
a relapse.” 
Comments. This is but one of many cases of the kind I might 
mention, in which there was no doubt as to the nature of the 
disease. The results of the treatment speak for themselves. Had 
the disease run on uninterruptedly it would soon have become 
much more formidable, if not absolutely incurable. 
957. Case II. Mr. S. W. II., aged forty, applied for advice 
in November, 1873. Had been in a decline for a considerable 
length of time, debility and emaciation were well marked, con- 
tinued cough with profuse expectoration, and shortness of breath, 
loss of appetite, night-sweats,—all spoke in unmistakable terms. 
He had severe attacks of bleeding from the lungs. Diagnosis.— 
Consumption. 
Treatment. The hygienic and dietetic treatment already 
recommended were advised and thoroughly carried out. The 
Discovery was the only medicine prescribed. After taking one 
dozen bottles, he writes: “ I feel like a new man; my improve- 
ment is wonderful; my friends can scarcely believe the evidence 
of their senses.” He continued the treatment for eight months 
and writes that he is a well man. 
958. Case III. Mrs. S. N., aged thirty, mother of two 
children, applied for treatment early in 1872. She was very 
much emaciated, great debility, pulse over one hundred, no 
appetite, pain in the chest, cough and expectoration severe. The 
respiratory sounds were very indistinct and confused, mixed 
with a bubbling noise as the air passed through the mucus in the 
air passages. Percussion showed a dull sound over upper part 
of the lungs. In addition, there was iiterine disease, prolapsus, 
enlargement and ulceration. Diagnosis.—Consumption, compli- 
cated with uterine disease. 
Treatment. Thorough hygienic regulations and diet as here- 
tofore were recommended. Discovery, with a drachm of fluid 
extract of veratrum to each bottle, teaspoonful four times a day 
was prescribed. Local applications, to heal the uterine ulcers, 
and to reduce the inflammation of that organ and restore its 
normal function were advised. Also directed Favorite Prescrip- 
tion to be taken three times a day. She remained under my 504 
COMMON SENSE MEDICAL ADVISER. 
care five weeks and left for home considerably improved. The 
journey, however, reduced her somewhat, but in four weeks she 
had regained what she lost, and was feeling better, with cough 
modified,and strength and appetite slightly increased. Prescribed 
special tonic, prepared for her individual case, and continued 
Discovery and veratrum, with the Favorite Prescription at night. 
In eight weeks more she wrote: “ I have improved so much you 
would scarcely know me, am gaining strength and all my old 
troubles are fast disappearing. I have an excellent appetite and 
have gained thirty pounds in weight.” Four months continuation 
of treatment and she was discharged, cured. 
Comment. This was a confirmed case, and badly complicated; 
but is only a fair sample of hundreds annually treated at the 
World’s Dispensary, and illustrates the success of my plan of 
treating this formidable disease. 
959. Case IV. Mr. E. G. R., aged twenty-six, lawyer, 
consulted me by letter, January 11th, 1871. His symptoms 
were, general debility, loss of flesh, and cough of several months 
standing,which annoyed him most, soon after rising in the morn- 
ing; very little expectoration, but quite a profuse discharge 
dropping into the throat from the nasal passages, took cold 
easily,was troubled with creeping chills running up and down the 
back, pulse, for four months, averaged one hundred and ten 
beats per minute, night-sweats, had three spells of bleeding 
from the lungs. He had been examined by several medical men, 
and his disease had been pronounced consumption by all. Diag- 
nosis.—Consumption. 
Treatment. Prescribed the general hygienic course heretofore 
recommended,with strict orders to eat largely of sweet cream and 
good butter. Directed Dr. Sage’s Catarrh Remedy to be used with 
my Nasal Douche, and teaspoonful doses of my Golden Medical 
Discovery, modified by one teaspoonful of fluid extract of verat- 
rum to each bottle, to be taken five times a day. March 15th, he 
wrote that he was greatly improved in health, had experienced 
one slight attack of hemorrhage since commencing treatment, 
but promptly arrested it by eating largely of common salt, and 
taking fluid extract of hamamelis 518), as I had advised him 
to do, in case it should return. He was advised to continue same 
treatment, which lie did for about six months, when he left off 505 
CONSUMPTION. 
all medicines, and has since enjoyed good health, as I am 
informed by a letter received from him during the month of 
December, 1874. Almost three years elapsed since he Avas 
under my treatment. 
960. C«t§e V. Samuel F., aged 23, book-keeper, applied at 
the World’s Dispensary in May, 1873, and was examined with 
the following results: Spirometer indicated diminished capacity 
of lungs; percussion over upper portion of left lung gave a dull 
sound, while auscultation revealed an unnatural respiratory mur- 
mur in the same locality. Pulse Avas one hundred per minute; 
respiration rather short, hurried and quite feeble. Food dis- 
tressed him, bowels were constipated, had frequent nightly 
emissions of semen; was impotent, gloomy, and despondent. 
Diagnosis.—Consumption, complicated with spermatorrhoea, 
the result of self-abuse,Avhich he acknowledged to have practiced 
from the time he was fourteen years of age. 
Treatment. As the digestive organs Avere weak, I could not 
advise the sweet cream and other oleaginous diet so beneficial in 
the preceding cases, until after toning up the stomach to a better 
performance of its functions. I therefore advised Graham bread, 
rare cooked beef, eggs, fish, oysters, etc.; enjoined outdoor 
exercise, bathing and other hygienic treatment, and gave Dis- 
covery modified with half a teaspoonful of Areratrum to each 
bottle. Dose—one teaspoonful four times a day Also gave my 
Stomachic Granules to overcome the dyspeptic symptoms and 
strengthen the stomach. A specific for the nocturnal emissions 
was given at bed time. This also combined properties to tone 
up the nervous system. This treatment operated like a charm 
and Avas continued for two months- Avithout change, except 
as the stomach became stronger the diet was changed to one 
embracing a liberal quantity of sweet cream, rich milk, good but- 
ter and fat beef. At the end of three months all medicines, 
except the Discovery, were omitted, and its continued use for 
four months longer resulted in a perfect restoration of health, 
which has continued uninterruptedly to the present time. 
961. The foregoing short list could he extended almost in- 
definitely, from the records of cases treated by the Medical 
Faculty of the World’s Dispensary. While I frankly ac- 
knowledge that our practice has been attended with occasional 506 
COMMON SENSE MEDICAL ADVISEE. 
failures, that mar the records, yet I claim for the treatment 
which I have outlined, a success heretofore unparalleled in the 
history of this distressingly fatal malady. 
ACUTE BRONCHITIS AND PNEUMONIA. 
962. Acute bronchitis is a disease of common occurrence, and 
in its milder form may pass, in popular parlance, as a “ cold on 
the lungs.” It is really an inflammation of the mucous mem- 
brane lining the bronchial tubes. The disease is severe in pro- 
portion to the extent of surface involved. It may be limited 
to the bronchial tubes, or it may extend to their minute rami- 
fications. 
963. Tile Symptoms will vary with the intensity of 
the malady. In the milder type, there will be a sense of tight- 
ness and heat in the upper portion of the lungs. The air passages 
may seem raw, sore, or tender. Hoarseness and a dry, harsh, 
croupy cough, in the early stage, with free expectoration in the 
more advanced stage, are prominent symptoms; those common 
to coryza (*j] 878) are also frequently present. If the disease 
is severe, the whole system sympathizes in the derangement. 
Cold chills run over the body, followed by flushes of fever. The 
pulse is rapid and hard, while the surface and extremities are 
cold. The bones ache, and there is general prostration. Unless 
timely aid be rendered, a fatal termination may ensue. 
964. Pneumonia or filing' Fever. This is an in- 
flammation of the substance of the lungs. As the symptoms of 
this disease, particularly in its early stage, are so similar to those 
of acute bronchitis, that the non-professionals, who are not sup- 
posed to be qualified for practicing auscultation (•f 683) and 
percussion 684), by which alone the two diseases can be 
distinguished with certainty, cannot be expected to discriminate 
between them, and since the treatment of the two maladies, in 
the initial stage, would be the same, I have classed the symp- 
toms common to the two, together, and shall pursue the same 
plan in giving the treatment. Bronchitis constantly accompa- 
nies inflammation of the substance of the lungs, and the 
disease may also be complicated by inflammation of the pleura, 
when it is designated as pleuro-pneumonia. Sharp, lancinating 
pains in the chest are characteristic of this complication. As in CHRONIC BRONCHITIS. 
507 
pneumonia a far greater amount of tissue is involved in the in- 
flammation, than in bronchitis, the attendant symptoms will be 
correspondingly more severe. 
965. Causes. These diseases are most frequently induced 
by a sudden check imposed upon the perspiration. Bronchitis 
sometimes results from the inhalations of irritating substances. 
It is many times a secondary result of eruptive fevers, whooping- 
cough and other debilitating diseases. 
966. Treatment. The course of treatment to he em- 
ployed in the early stages of these diseases will not essentially 
differ from that already given in *[[879, for influenza. The 
spirit vapor-bath 630), with very full doses of my Compound 
Extract of Smart-Weed, hot fomentations applied to the chest, 
and two drop doses of tincture or fluid extract of veratrum, re- 
peated every hour, will generally break up the disease if resorted 
to early. Should the cough be dry and troublesome, three to five 
drop doses of tincture or fluid extract of lobelia may be given, 
every two hours, wdth mucilaginous drinks, such as flax seed or 
slippery elm tea. If the active inflammation is arrested by this 
course of treatment and should the cough, at the same time, 
not fully subside, my Golden Medical Discovery should be taken 
until it is thoroughly subdued, for, if allowed to continue, it is 
liable to result in chronic bronchitis or consumption. Should 
the disease not promptly yield to the treatment which I have 
advised, the family physician should be summoned to take 
charge of the case. 
CHRONIC BRONCHITIS. 
967. This is a subacute form of inflammation of the mucous 
membrane of the bronchial tubes, of a very persistent character 
and variable intensity. There is always cough, which is accom- 
panied by more or less profuse expectoration, of a mucous or 
muco-purulent character, and sometimes streaked with blood. 
It is a common form of disease in this country, and may be met 
with in all stages of life. It is common to the aged, among 
whom it occurs without any obvious cause, and often continues 
during life. There are few diseases that manifest a greater 
variety of modifications than this. It is met with presenting 
symptoms so mild as to attract little or no attention, from which 508 
COMMON SENSE MEDICAL ADVISER. 
it may progress to the most grave and obstinate form of the 
disease, and perhaps terminate in consumption. Its progress is 
sometimes slow and insidious, at other times rapid. It is often 
associated with laryngitis, either as a cause or an effect, by the 
extension of the disease along the mucous membrane, which is 
continuous throughout these organs. It often occurs in connec- 
tion with disease of the heart and kidneys, and tends to the 
development of asthma. There is often irritation of the filaments 
of the pneumogastric nerve, which increases the cough, and 
causes it to occur in paroxysms. There is little or no tendency 
to spontaneous recovery. Occasionally, it continues for years 
without becoming worse, until some derangement of the system 
occurs, when it may be aggravated and prove rapidly destructive. 
Again, it may take on a rapid and severe form from the first. 
It presents a great variety of symptoms, according to the severity 
of the disease, and the rapidity of its progress. Physicians not 
thoroughly experienced and skilled in the practice of examining 
the chest by measurement, auscultation 683), and percussion 
*684), are frequently not able to distinguish between this 
disease, in its various stages, and pulmonary consumption. 
968. Causes. The causes of chronic bronchitis are various. 
It may occur as a result of the acute form of the disease, and is 
a frequent termination of colds, influenza, whooping-cough and 
diphtheria. Constitutional syphilis contributes to its existence, 
and so do organic diseases of the heart and kidneys. It is fre- 
quently associated with rheumatism. It often follows measles 
and other eruptive fevers, protracted disease of the biliary organs, 
and the recession of cutaneous complaints. The inhalation of 
irritating substances, to which millers, stone-cutters, workers 
in metals, etc., are exposed, is liable to produce this ailment. 
Affections of the throat—pharyngitis, laryngitis, and that pecu- 
liar trouble to which public speakers are liable, frequently 
extend downward through the windpipe to the air tubes and 
cause bronchitis. The most frequent cause is the changeable 
weather incident to certain climates—the sudden transition from 
hot to cold, from dry to moist atmospheres, and vice versa. 
Anything that interferes with the healthy- function of the skin, 
impeding elimination through this gland, throws an increased 
amount of labor on the pulmonary membranes and is liable to CHRONIC BRONCHITIS. 
509 
cause this disease. Neglected catarrh is also a fruitful cause of 
this affection, in consequence of the morbid products resulting 
from it, dropping into the throat, and being forced farther and 
farther into the air passages every time the breath is inhaled, 
until they excite cough and are expelled. By their presence 
they incite morbid action in every membrane with which they 
come in contact. The system may be predisposed to this affec- 
tion by any of the causes which produce consumption; when the 
disease is once established, it is very easily perpetuated by any 
of those causes which interfere with the proper performance of 
the various functions, or tend to debility. 
969. Syilipt©Sll§. The symptoms of this disease vary 
greatly with its violence and progress. Cough is always present 
and is very often the first symptom to attract the patient’s atten- 
tion. It is usually increased by every slight cold, and with each 
fresh accession becomes more and more severe, and is thrown off 
with greater difficulty. The cough is always persistent, some- 
times short and hacking, at other times deep, prolonged and 
harsh. Sometimes it is spasmodic and irritative, and particularly 
so M-hen it is associated with affections of the larynx or with 
asthma, involving irritation of the branches or the filaments of 
the pneumogastric nerve. 
When the chronic follows the acute form of the disease, or 
follows inflammation of the lungs, the expectoration may be 
profuse from the first, and of a yellowish color and sticky qual- 
ity. When the disease arises from other causes, the expectora- 
tion will at first be slight and the cough dry or hacking; this 
may continue for some time before any expectoration occurs. 
It will at first be whitish, opaque and tenacious, mixed some- 
times with a frothy mucus, requiring considerable coughing to 
loosen and throw it off. As the disease progresses it becomes 
thicker, more sticky, of a yellowish or perhaps greenish color, 
mixed with pus, and it is sometimes streaked with blood. In the 
latter stages it becomes profuse and fetid and severe hemorrhage 
may occur. Sometimes the cough and expectoration disappear 
when the weather becomes warm, to re-appear again with the re- 
turn of winter, which has gained for it the appellation of ivinter 
cough. There is generally little or no fever, though the pulse may 
be accelerated and sometimes to a considerable extent. Usually 510 
COMMON SENSE MEDICAL ADVISEE. 
a shortness of breath is observed, with a sense of constriction 
around the chest. The sufferers feel as if there was something 
bound tightly round them, rendering inhalation difficult. Sore- 
ness throughout the chest is often a persistent symptom, 
especially when the cough is dry and hard. Behind the breast- 
bone there is experienced a sense of uneasiness, in some cases 
amounting to pain, more or less severe. In females, when the 
bronchitis is associated with uterine derangement, as it very often 
is, a sense of constriction and weight, a dragging down feeling 
is usually experienced behind the breast-bone, where the trachea 
divides into the bronchial tubes. If the disease is allowed to 
progress, the skin becomes dry and harsh, the tongue coated in 
the morning, and the appetite more or less impaired; the bowels 
become irregular, the urine high colored, the pulse weaker and 
increased in frequency, with all the other symptoms of confirmed 
consumption, from which it can only be distinguished by 
auscultation 683) and percussion 684). 
The general symptoms vary greatly with different cases; some- 
times the disease continues for years with but little change; 
the individual wonders why he takes cold so easily, and that it 
settles upon the lungs, and that each succeeding one becomes 
worse; but, sooner or later, the sufferer loses flesh and strength, 
nutrition is disturbed, and all the functions become deranged. 
Generally, when the disease is established, the patient becomes 
anaemic 772), the appetite impaired, the circulation deranged, 
and all the secretions affected. As the disease progresses, the 
loss of strength is more and more marked, the patient is no 
longer able to follow his usual employment, his spirits are 
depressed, and he gradually sinks, or else tubercles are developed 
in the lungs, and he dies of true consumption. 
970. Curability/ Respecting the curability of this dis- 
ease, but little need be said. In its early stages it readily yields 
to appropriate treatment of a hygienic and medicinal character. 
Change of climate has been known to effect its removal, and it 
has subsided on the cessation of the exciting causes, yet such 
occurrences are rather the exceptions. While it yields quite 
readily to proper treatment, it has little or no tendency to cease 
spontaneously. As it progresses, it becomes more severe, the 
constitution is deeply involved, and it acquires an obstinacy that CHRONIC BRONCHITIS. 
511 
demands the most skillful treatment for its removal. As its 
severity increases, in consequence of its progress, or from com- 
plication with other affections, its curability diminishes, and new 
principles of treatment, to correspond with the complications, 
are necessary. Under properly adapted treatment, nearly every 
case is curable, yet there are instances which terminate fatally 
by interfering with respiration and causing death by asphyxia 
(suffocation). Such terminations are rare, the disease, if not ar- 
rested, more frequently merging into consumption; or death 
results more directly as a termination of the diseases with which 
it may be complicated, as those of the heart and kidneys. Under 
proper management, fatal cases are the exceptions, and many of 
the complications which arise as it progresses, can be obviated. 
The great danger from it, arises generally from its complications, 
so that it is dangerous indirectly rather than directly. 
971. Treatment. Thorough attention to hygiene, with 
the avoidance of the causes concerned in its production and per- 
petuation, are necessary. The patient must be protected from 
the vicissitudes of the weather by plenty of clothing; flannel 
should be worn next to the skin, with a pad of flannel or buckskin 
over the chest, and the feet should be kept warm and dry. 
Plenty of exercise in the open air is essential. When the weather 
is so cold as to excite coughing, something should be worn over 
the mouth, as a thin cloth, handkerchief, muffler, or anything 
that will modify the temperature of the atmosphere before it 
comes in contact with the mucous lining of the lungs. Good 
ventilation of sleeping rooms, is all-important; not that the air 
should be cold, but that it should be as pure as possible. The 
avoidance of all causes likely to derange the general health, and 
thus indirectly aggravate the disease, is but the dictate of common 
prudence. The system must be maintained in good condition, 
to prevent the development of tubercles, or other complications 
which are liable to arise from constitutional derangement, and at 
the same time the inflammatory process going on must be over- 
come. In order to accomplish this, the treatment will be based 
upon the following indications: 1st. To secure and maintain a 
healthy standard of all the functions, and thus prevent compli- 
cations. 2d. To overcome the modified inflammation existing in 
the bronchial mucous membrane. 512 
COMMON SENSE MEDICAL ADVISER. 
972. To fulfill the first indication will indirectly influence the 
second. The function of nutrition is very apt to become im- 
paired as the disease progresses, and in consequence general 
deterioration occurs. The advice laid down and fully considered 
under consumption, is appropriate here. The diet must be nu- 
tritious, carbonaceous, and of sufficient quantity. Beef, milk, 
rich cream, plenty of good butter, eggs, fish, wheat bread from 
unbolted flour, supply the appropriate alimentary substances for 
perfect nutrition and maintenance of animal heat. 
973. The Skin is intimately associated with the functions of 
the lungs, and influences the retrocession or advancement of the 
disease, as its function is properly or improperly performed. In 
this disease its disposition is to become dry and harsh. This 
should be overcome by the frequent use of the warm-bath, the 
beneficial effects of which are sometimes increased by the addition 
of a little salt. The spirit vapor-bath 630) once a week, is an 
invaluable adjunct to other* treatment of the disease. 
974. To fulfill the second indication — to overcome the modi- 
fied form of inflammation in the bronchial tubes — all sources of 
irritation must be avoided, as inhalation of dust, excessively cold 
air, etc. It is in the cure of severe and obstinate cases of this 
disease that my Golden Medical Discovery has achieved unparal- 
leled success, and won the loudest praise from those who have 
used it. Its value will generally be enhanced in treating this com- 
plaint by adding one-half a teaspoonful of the fluid extract of ver- 
597) to each bottle. Especially should it be thus modified 
if the pulse is accelerated so as to beat ninety or a hundred times 
in a minute. The Discovery should be taken in teaspoonful 
doses, repeated every two hours. When the cough is dry and 
hard, with no expectoration, it arises from irritation of some of 
the branches of the pneumogastric nerve, which the Discovery 
will relieve. It may, however, be aided by inhaling the hot 
vapor of vinegar and water, or vapor from a decoction of hops, 
to which vinegar has been added. Although the tightness of 
the cough may sometimes seem to demand expectorants, yet their 
use will invariably be attended by injury. If any explanation of 
their injurious effects is desired, I will refer the reader to 582, 
where their action is fully considered. The treatment already 
advised will be sufficient for the cure of uncomplicated cases. CHRONIC BRONCHITIS. 
513 
975. Treatment of Complicated Cases. When bleeding from 
the bronchial tubes occurs, the remedies advised for hemorrhage, 
in 950, should be given. If the disease is associated with affec- 
tions of the heart or kidneys, or with asthma, the treatment 
prescribed for these diseases will be useful, but they are too 
serious maladies to be trifled with, and should receive the atten- 
tion of some skilled specialist. 
976. The Liver is a very important organ, and derangement 
of its functions is soon felt, the lungs suffering materially there- 
from. Its restoration to health often exerts a wonderful 
curative influence upon diseases in remote parts of the body. 
When the Golden Medical Discovery, which has already been 
advised, is not sufficient to restore this gland to a healthy condi- 
tion, my Pleasant Purgative Pellets should be taken in doses of 
one or two every night to secure their alterative effect on the 
liver. 
977. The Kidneys often become involved in the disease 
and fail to secrete and remove from the system broken down 
materials. The remedies already advised are generally sufficient 
to restore them to a healthy condition. Should anything farther 
be required to renew their functional activity, an infusion of 
queen of the meadow (1" 559) may be employed; or the acetate 
of potash 569) will act well for this purpose. 
978. Menstruation. The menses are often deranged 
during the progress of this disease. Their restoration is import- 
ant; in addition to the treatment already advised I would 
recommend my Favorite Prescription which is w'ell adapted to 
restore this function, and will not interfere with, but rather 
enhance the action of the remedies already advised for this 
affection. 
979. While there are many cases, as has already been seen, 
that are mild and plain, and can be treated by the patients them- 
selves, there are others which, from their severity, having 
passed to the second or third stages, or from being complicated 
with other affections, require the very best judgment and skill 
in their treatment. Many times it is difficult to distinguish 
chronic bronchitis from other pulmonary diseases; in all 
such cases as involve difficulty or doubt, I would advise 
the patient to consult some skillful physician, in whom he may 514 
COMMON SENSE MEDICAL ADVISER. 
have confidence, and not endanger his life by trying experi- 
ments, nor by procrastination. 
980. Treatment by Specialists. Physicians making 
the treatment of pulmonary diseases a special study are usually 
much better supplied with the necessary instruments and means 
of investigation and diagnosis, than those employed in general 
practice, and are better qualified to treat them. Medical and 
surgical instruments are very expensive and cannot be afforded 
by those who have little or no use for them, while to the 
specialist, those belonging to his particular branches of practice 
are indispensable in consequence of their frequent employ- 
ment and the greater skill achieved through their use. In 
selecting a specialist, be careful to consult one who has an 
established reputation for integrity and skill. 
CASES TREATED. 
981. Case I. Daniel A., aged thirty-five, had been for 
several years troubled with cough and expectoration, difficulty 
of breathing and soreness under breast-bone; noticed that going 
from a warm room into the cold air excited a paroxysm of 
coughing. Took cold easily, each succeeding one becoming 
more severe; for several years did not pay much attention to it, 
until the general health began to fail, and emaciation, loss of 
strength, cough and difficulty of breathing, increased. Percussion 
showed increased resonance. Auscultation showed mucous 
sounds in air passages. Diagnosis.—Chronic Bronchitis. 
Treatment. Advised the hygienic treatment heretofore laid 
down, and my Golden Medical Discovery. He persisted in its 
use for several months, and fully recovered, passing the next 
winter with no return of his difficulty. 
Comment. This case was a simple one, although some little 
discrimination was required to distinguish it from the initial stage 
of consumption. The treatment was equally simple and effectual. 
982. Case II. Geo. R. B., aged twenty, had an attack of 
acute bronchitis in February, 1873, and although the acute inflam- 
mation subsided under the management of his physician, yetffie 
did not fully recover. There was severe cough, with expectora- 
tion of large quantities of thick, yellow, flaky matter. Pulse 
quick, complexion sallow, bowels constipated, skin dry, urine CHRONIC BRONCHITIS. 
515 
high-colored and scanty, appetite poor, emaciation marked. By 
means of the spirometer, aided by auseulation and percussion, a 
Diagnosis of Chronic Bronchitis was clearly made out. 
Treatment. Thorough hygiene, warm alkaline-bath (1 644) 
twice a week. Diet, milk, cream, eggs, beef, Graham bread, 
oysters, etc. The Golden Medical Discovery, with half a tea- 
spoonful of fluid extract of veratrum added to the bottle, to 
control the excitement of the circulation, was given in tea- 
spoonful doses every two hours, and two of my Purgative Pellets 
each alternate night. In addition to this, a pill containing two 
grains each of quinine and carbonate of iron was given after each 
meal. He began to improve at once, and in two months was 
able to be about and attend to light business. All medicine, 
except the Discovery, was then omitted. He continued the use 
of the latter for some months, when he was perfectly well, and 
remains so to the present day. 
Comment. It is scarcely necessary to say that this case was a 
severe one, and had been pronounced consumption by the family 
physician. Improved methods of diagnosis placed it in its proper 
light, and led to correct and successful treatment. 
983. Case III. Mary II., aged thirty, consulted me by 
letter, in May, 1873. She had severe cough, occurring in par- 
oxysms, attended with great difficulty of breathing. The expec- 
toration was profuse and of a yellowish green color, and very 
offensive. She had pain and a dragging sensation under the 
breast-bone, with soreness and a sense of constriction through 
the chest. Palpitation was experienced on slight exertion. She 
stated that she was pale, bloodless, nervous and despondent. Her 
appetite was poor, skin dry and harsh, urine rather copious and 
pale. There was pain and dragging in the back and loins, and 
menstruation was scanty, pale, and attended with considerable 
pain. She also had a profuse leucorrhoeal discharge. Diag- 
nosis.—Chronic Bronchitis, complicated with anaemia and uterine 
derangement. 
Treatment. Thorough hygiene, the best and most nutritious diet 
embracing plenty of animal food. The spirit vapor-bath 630) 
once a week. The surface of the whole body to be sponged with 
alcohol diluted with water after the sweating had ceased. The 
Golden Medical Discovery with veratrum (one-half teaspoonful 516 
COMMON SENSE MEDICAL ADVISEE. 
to each bottle), teaspoonful three times a day, before meals, and a 
mixture containing iron was given after meals, so that she would 
take a grain of the pyrophosphate at a dose, and two teaspoon- 
fuls of the Favorite Prescription at night. For the leucorrhcea, 
Sage’s Catarrh Remedy was used as a vaginal injection. Under 
the influence of this treatment, she slowly and gradually im- 
proved. At the end of four months she was so much better 
that all medicine except the Discovery and Favorite Prescription 
was discontinued. These she continued for sometime longer, 
until her xisual health was regained, and which she still enjoys. 
Comment. This case speaks for itself. Uterine derangements 
are very frequent complications of chronic bronchitis, though 
amenable to proper treatment. This case is but a specimen of 
hundreds that annually apply to me either by letter or in person 
for treatment. 
ACUTE PLEURISY. 
984. It will be seen by referenee to 73 of this work, 
that the cavity containing the lungs and heart, and known as the 
thorax, is lined by a serous membrane called the pleura. This 
membrane, springing from the root of the lungs, envelops each 
lobe separately—forms a partition wall between them, (the medi- 
astinum), and is thence reflected over the diaphragm (midriff). 
Like the lungs themselves, it may become the seat of inflam- 
mation. If this membrane is the only part affected we have 
simply pleurisy. If the lungs share in the inflamed condition 
we have pleuvo-pneumonia. 
Acute pleurisy may arise from a variety of causes. A violent 
strain or other injury may induce it. It may occur in con- 
sequence of the retrocession of other diseases, as erysipelas, 
rheumatism, measles, etc. Most frequently, however, it is the 
result of sudden exposure to cold or dampness, when in a state 
of perspiration. Fortunately for the sufferer the disorder is 
usually confined to one side. This is not always the case, how- 
ever, and when it becomes general, the suffering is great and the 
probabilities of a fatal termination are largely increased. The 
severer manifestations are usually ushered in by a well defined 
chill. Sometimes before, but usually immediately after this, a 
sharp, cutting or pricking pain is felt in the affected side, with ACUTE PLEURISY. 
517 
every effort at inspiration. The lungs are but partially inflated, 
when the sensation as of a sudden stab causes expulsion of the 
breath. It is impossible to lie on the affected side. At the same 
time there is high fever, the pulse being hard, small and rapid, 
reaching to 120 or 140 per minute. As in fevers, not of a sym- 
pathetic character, the tongue is coated, skin harsh and dry and 
urine scanty. A dry hacking cough harrasses the victim, but he 
will suppress it as much as possible on account of the pain that 
attends it. The lancinating pain will indicate the seat of the 
complaint. It may be underneath the heart, or at a lower point. 
If in the diaphragm, it will be near the lower part of the chest. 
After a lapse of time, varying in different cases, the inflamed 
surface discharges a watery fluid similar to that issuing from a 
blister. This is called “effusion.” When this occurs, the pain 
is less severe, but the oppression and difficulty of breathing 
remain. The fever is diminished, the extremities are cold, the 
cough is somewhat looser, and there is great physical pros- 
tration. These are the prominent symptoms of the different 
stages. 
985. Treatment. Prompt, domestic treatment, in the 
initial stages, will many times arrest the disease, and when it 
does not, will at least lessen its severity and render the labors of 
the physician easier and his success more certain. In all such 
cases there is a determination of blood to the affected part. We 
should, therefore, strive to equalize the circulation. To accom- 
plish this, the spirit vapor-bath 630) will be very useful. My 
Compound Extract of Smart-Weed is a superior remedy to apply 
externally to the chest, and also to take internally, as it induces 
sweating, and, by its anodyne properties, allays pain. Hot 
fomentations should also be freely applied to the chest, and 
changed often, to keep them as hot as the patient can bear. 
The administration of tincture of aconite (596) in doses of two 
or three drops every hour, will by its powerful sedative and ano- 
dyne properties, aid materially in controlling the inflammation 
and relieving the pain. 
As already hinted, however, too great a reliance must not be 
placed upon domestic treatment. In anything like a severe 
attack of this disease, I would recommend that the family physi- 
cian be called. The course advised will be attended with benefit 518 
COMMON SENSE MEDICAL ADVISER. 
in every case, but still more active remedies, in more skillful 
hands, may be needed to accomplish a cure. 
986. This is primarily a disease of the nervous system, invol- 
ving the respiratory organs through the medium of the pneumo- 
gastric nerve. It is considered a disease of childhood, though I 
have met with it in old age. It is eminently a contagious affec- 
tion and occurs but once during life. 
WHOOPING-COUGH. (Pertussis.) 
987. Symptoms. It is at first manifested by a catarrhal 
cough, gradually developed. After a while it becomes par- 
oxysmal, generally worse at night. The cough is peculiar, severe, 
and continued; when a prolonged inspiration occurs, it is accom- 
panied by a peculiar shiill sound — the characteristic wlioop — 
which, when once heard is never forgotten. The cough is atten- 
ded by a copious secretion of glairy mucous, which is brought 
up at the latter part of the paroxysm. During, or at the end of 
the paroxysm, vomiting frequently occurs, and sometimes nose- 
bleed. The cough is so severe at times, that the patient turns 
purple, gasps for breath, and presents all the symptoms of suffo- 
cation. Bronchitis sometimes is a troublesome complication. 
Immediately preceding a paroxysm of coughing, a sense of im- 
pending danger appears to seize the child, and it runs to its 
mother, or grasps some support as if for protection. Until the 
paroxysmal character and peculiar whoop is developed, the dis- 
ease is diagnosed with difficulty. 
988. Treatment. I have found my Golden Medical 
Discovery to modify the disease and cut it short. The philosophy 
of its action can he readily understood by its effect on the 
pneumogastric nerve, as explained under Consumption and Bron- 
chitis. Having had ample opportunity to observe its action and 
efficacy in the case of my own children, I can recommend it with 
a confidence which I do not possess in any other remedy. The 
employment of an infusion of red clover blossoms, in small doses, 
is of undoubted value in modifying the irritation of the air pass- 
ages, and may be used to good advantage with, or in alternation 
with, my Golden Medical Discovery. Indeed, so great is my con- 
fidence in these remedies, that I shall not recommend any other. 
As a matter of course, hygiene must not be lost sight of. ASTHMA. 
519 
ASTHMA. 
989. This is a serious affection; not because of its fatality, 
for it seldom terminates life, but on account of the suffering 
it occasions. That the paroxysms, when frequent and severe, 
tend to shorten life by interfering with the operations of the 
heart, and thus deranging the circulation, cannot be doubted. 
Still it is very seldom, if ever, that persons die, as a direct result 
of the asthmatic spasm. 
It is not, properly speaking, an organic lung disease, but 
merely a nervous affection of the respiratory passages. The seat 
of the disorder is by some supposed to be in the medulla oblon- 
gata 118). This being deranged by congestion, stimulation, 
or otherwise, the disturbance is transmitted through the cervical 
and pneumogastric nerves to the air-cells of the lungs, causing 
spasmodic contraction, and thus rendering the act of respira- 
tion extremely difficult. In consequence of this contraction, the 
inhalation of fresh air is rendered almost impossible. 
An attack may come on, with or without premonition. When 
warning is given, the patient experiences a sense of fullness in 
the stomach, flatulence, headache, languor, and genei’al nervous 
irritability. The most usual time for its occurrence is in the 
night, though it is not confined to it. The patient is first 
seized with great anxiety, attended by a sense of tightness 
or constriction of the throat. Then there is cough, and he has to 
work hard to breathe. He changes his position, sits upright, leans 
forward upon his knees, jumps up, rests his head upon a table or 
chair, rushes to the window for air, and gasps and struggles for 
breath. His face expresses great suffering. The eyes are 
prominent, and the veins of the forehead are distended with 
blood. Sometimes the bowels are relaxed. The urine is usually 
copious and colorless. The voice is hoarse, articulation diffi- 
cult, breathing—what little there is of it—wheezy. A severe 
paroxysm of this disease is most distressing to witness; and one 
unused to it might well suppose that the sufferer was in his 
last agonies. No definite limit can be assigned, as regards the 
duration of the paroxysms. They may last but a few minutes, 
may endure for hours, or with slight remission, continue for days. 
990. Ciitises. Asthma is hereditary in many cases. In all 520 
COMMON SENSE MEDICAL ADVISER. 
instances there must be a constitutional predisposition before an 
attack can occur. Without this, no amount of exciting causes can 
produce the result. With it, there are many circumstances which 
are capable of exciting it, as atmospheric variations, changing 
from one locality to another, sleeping in certain rooms, inhala- 
tion of dust or gases. Many persons are so sensitive, that chang- 
ing their sleeping apartment from the front to the back side of the 
house, or coming into the presence of certain animals, as horses, 
cats, dogs, etc., is enough to excite an attack. Irritation, reflected 
from various parts of the body, frequently causes it, and it ofted 
exists as a complication of bronchitis or heart disease. 
991. Treatment. This may be divided into palliative 
and curative. Palliative when the relief of the paroxysm is the 
object in view. Curative, when both the relief of the paroxysm 
and prevention of its recurrence is sought. 
For the relief of the paroxysm, an emetic dose of lobelia 
(If 573), to be followed by nauseous doses of the same, generally 
furnish prompt relief, but do not afford immunity from a 
recurrence. Inhalations of chloroform or ether, are sometimes 
very efficient and prompt, but in other cases they aggravate the 
paroxysm. Breathing the fumes of burning saltpetre is sometimes 
equal to the emergency. Changing from one locality to another 
will, many times, suddenly terminate an attack. Two brothers 
of my acquaintance, residing fifteen miles apart, could not visit 
each other and remain over night without its inducing a par- 
oxysm of asthma, which would be so severe as to necessitate 
their return home, when the attack would at once cease. 
992. Curative Treatment. The causes of the disease, when 
they can be ascertained, should be avoided. AVhen due to 
climatic influences it can only be permanently cured by a change 
of residence. When due to other diseases, as of the stomach, 
heart, lungs, uterus, etc., its cure can only be effected by curing 
the disease of which it is a complication. It is sometimes caused 
by malarial influences. When this is the case, my Golden Medical 
Discovery, or that remedy combined with small doses of quinine 
will be sufficient. Its most frequent cause being irritation 
reflected through the pneumogastric nerve, or its filaments, a 
relief of this is necessary, and must be accomplished between 
the attacks. The well-known influence of my Golden Medical DISEASES OF THE HEART. 
521 
Discovery upon this nerve, as explained under consumption, ren- 
ders it one of the most efficient remedies prescribed, and its 
employment for this purpose has been attended with the most 
gratifying results. In all cases, due attention to the bowels is 
necessary; if costive, my Pleasant Purgative Pellets, used in 
very small doses, for a considerable time, so as to secure 
their alterative influence, are advisable. 
993. The irritability of the air-cells themselves often produces 
frequent attacks, upon the occurrence of the most trivial causes, 
and thus prevents the efficacy of curative treatment. The 
addition of two drachms of fluid extract of lobelia to 
each bottle of Discovery, or the separate employment of lobelia, 
is generally sufficient to prevent the paroxysms. 
994. Case I. Mr. J. P. R., consulted me for asthma in 1872. 
On examination I found it to be due to irritation of the pneumo- 
gastric nerve, and prescribed thorough hygiene—care in eating, 
attention to bowels and skin—with the use of my Golden Medi- 
cal Discovery. The attacks became less frequent for a month 
or so and finally the paroxysms disappeared altogether. 
CASES TREATED. 
995. Case II. J. E. C., in 1871, suffered from asthma, in 
which there was irritability of the air-cells, frequent and severe 
paroxysms with cough and expectoration. Prescribed the Dis- 
covery with two drachms of fluid extract of lobelia to each 
bottle. Result—a cure in three months. 
996. Case III. Mary H., aged thirty; asthma complicated 
with uterine disease and dyspepsia. Began the treatment by ap- 
propriate remedies for the uterine disease, which I believed was 
the exciting cause-of the whole trouble; also prescribed remedies 
to give temporary relief. This treatment soon had the effect of 
relieving the reflex irritability on which the disease depended, 
and at the end of three months all medicines but the Discovery 
and Favorite Prescription were discontinued and the cure 
completed with these. She remains perfectly well. 
DISEASES OF THE HEART. (Functional Diseases.) 
997. Diseases of the heart are classified as either Functional 
or Organic. We shall dwell briefly, first, upon purely f unctional 522 
COMMON SENSE MEDICAL ADVISER. 
disorders of the heart, which are distinguished by there being 
no inflammation or disease of its structure. The functional dis- 
turbances of the heart are very naturally divided as follows: 
Increased or excited action, Defective or enfeebled action, Irregu- 
lar action, and Neuralgia, also termed Angina Pectoris. 
998. Increased action of the heart, indicated by palpitation, 
or its stronger beating, may be caused mechanically, 1st, by dis- 
tention- of the stomach, which, by preventing the descent of the 
diaphragm, excites the action of the heart; 2d, distention of the 
transverse colon pressing on the aorta 66, Fig. 41), causing 
congestion of blood on the left side of the heart; 3d, distention 
of both these organs which press on the ascending vena cava, 
hindering the return of blood to the right side of the heart; 4tli, 
enlargement of the liver, producing the same effect. 
999. Increased action of the heart may be a sympathetic, 
disturbance produced through the nervous system; as, 1st, the 
emotions and passions may suddenly arouse the heart to excessive 
action; 2d, the presence of worms in the intestines, improper 
food, or self-abuse, etc., may be the cause; 3d, it may arise from 
irritation occasioned by the stimulus of the blood, which may 
result from two causes, viz., excess in quantity, as in a plethoric 
state of the system, due to morbid activity of the nutritive func- 
tions, or change in quality, in consequence of the morbid con- 
dition of other organs. A temporary excess in quantity may 
be due to cold, or congestion from overdoing and exhaustion; 
but more commonly, in plethoric persons, the palpitation of the 
heart is in consequence of an overplus of red corpuscles of the 
blood, and the condition then is permanent. Increased action of 
the heart is often caused by an alteration of the quality of the 
blood by retention of matters which should be excreted; in 
case of faulty action of the kidneys, alkalies or acids may be 
retained in the blood. Suppression of perspiration or retention 
of bile sometimes produces the same results. The use of tea, 
tobacco, and alcoholic drinks, excites the heart. Deficiency 
of the blood, as in anaemic persons, may be the cause of palpi- 
tation of the heart. 
1000. Increased action of this organ may he due to enhanced 
irritability of the heart itself. Its muscular fibers possess a 
peculiar nervous endowment, and its sensitiveness when unduly DISEASES OP THE HEART. 
exalted, easily responds by quicker action, and it is generally 
associated with an increased sensibility of the nervous system. 
1001. Functional disturbance of the heart’s action is mani- 
fested by palpitation, acceleration, irregularity, intermissions, a 
rolling or tumbling movement and a feeling as though the heart 
was in the throat. These disorders give rise to great apprehen- 
sion, worry, anxiety, fear, depression of spirits, and mental states 
which predispose to organic disease of the heart. The belief 
that the organ is diseased in its structure tends to develop such 
lesions, and hence it is extremely desirable to be able to deter- 
mine with certainty whether the derangement be a case of mere 
functional difficulty or of actual disease. 
1002. Treatment. The curative treatment of functional 
disorder of the heart must have reference to the causes produc- 
ing it. If the physician does not have a knowledge of all the 
circumstances connected with it, hygienic management will be 
of no avail. If it is in consequence of indigestion, domestic 
management must improve the appetite and digestion, by observ- 
ing regularity in the time of taking the meals, and preparing 
very easily digested, food. The use of strong tea, coffee, tobacco 
and spirits should be interdicted, and regular exercise, rest and 
sleep must be enjoined. The physician will prescribe such tonic 
and alterative remedies as the patient can bear, and adapt a 
treatment suited to the dyspeptic condition of the stomach. 
1003. When functional disorder of the heart is caused by ex- 
cess of blood and inordinate activity of the nutritive functions, 
the patient must practice abstinence in diet, and increase the 
amount of physical exercise. There are few who are willing to 
practice such self-denial, but it is imperatively necessary. Less- 
ening the amount of nutritive supply, and increasing the expen- 
diture of the system by mental and physical labor, will in time 
diminish the superabundant volume of blood, and lessen its 
immoderate stimulus. In all cases the domestic management 
must include daily bathing, exercise in the open air, regular 
habits, and the avoidance of all known causes which tend to ex- 
cite the heart’s irregularity. 
1004. The Remedial Treatment of these functional disorders 
ought to he confided to some experienced physician, to whom a 
full history of all the attending symptoms should be carefully 524 
COMMON SENSE MEDICAL ADVISER. 
given, and who then will be able to judge correctly of the causes 
which produce the disorder. He can also connect it with the 
circumstances and condition of the general system, and prescribe 
remedies which may obviate derangements, and restore all the 
organs to health. This course of treatment, it is obvious, cannot 
be pursued with advantage by the non-professional; the remedies 
are not within the ordinary reach of all families, nor if they 
were, would they have sufficient experience and knowledge to 
select and rightly administer them. For these reasons I advise 
them to apply for their treatment to those who have had expe- 
rience, and who are entitled to their confidence. 
ORGANIC DISEASES OF THE HEART. 
1005. By organic disease I mean disease pertaining to the 
heart itself, in contradistinction to functional disease which has 
reference merely to the action of the heart. The heart is subject 
to various organic diseases, among which we may mention Hy- 
pertrophy, Dilatation, Atrophy, Fatty Degeneration, Valvular 
Lesions, Pericarditis and Endocarditis. 
1006. Hypertrophy, from its Greek .derivation, signifies 
to overnourish. By hypertrophy is understood a thickening of 
the muscular substance of one or more of the cavities of the 
heart. In chronic diseases the region in front of the heart is 
generally prominent; the pulsations are observed to extend over 
a larger space than is natural, and the vibrations can be plainly 
felt when the hand is placed upon the cardiac region. The pulse 
is usually strong and full. Hypertrophy is of itself seldom fatal; 
it rarely proves so, except from causes which have given rise 
to it, or from diseases which it may induce in other organs. It 
may exist to quite a considerable extent, without any symptoms 
which would lead a person to suspect the existence of disease. 
Hypertrophy is often combined with dilatation and contraction 
of the heart, or ossification of the valves. 
1007. IHlsitatioil in most cases arises from weakness of 
the muscular walls, fatty degeneration, etc. In this affection the 
chief symptom is weakness of the action of the heart, as shown 
by a feeble pulse; but when dilatation is combined with hyper- 
trophy, the pulse is strong, full and hard, and the beat of the 
heart becomes more and more tumultuous. ORGANIC DISEASES OF THE HEART. 
525 
1008. Atropliy is the opposite of hypertrophy, and signifies 
a wasting away, or a dimunition in the thickness of the walls of 
the heart. Its muscular power is diminished in proportion to 
the degree of atrophy. 
1009. Fatty Heg'eneratioil is the deposition of par- 
ticles of fat within the sarcolemma (the sheath which invests a 
fibre) and are substituted for the proper muscular tissue. If the 
fatty degeneration exists to any amount, the muscular walls pres- 
ent a yellowish color, and the heart is soft and flabby. This 
may be confined to one ventricle, or it may affect the inner layer 
of fibres, the outer layer remaining unchanged. Degeneration 
of the left ventricle occasions feebleness of the pulse, and the 
heart is enfeebled in proportion to the disease. Difficulty in 
breathing is one symptom of this disease, especially when the 
right ventricle is affected. Symptoms resembling those of apop- 
plexy, such as a pallid surface, feeble circulation, etc., have been 
observed in persons who have died of this affection. Fatty de- 
generation is more liable to occur in corpulent persons, and 
between the ages of forty and fifty years. 
1010. Valvular FesioilS. I have already noticed en- 
largement of the heart under the head of hypertrophy, which 
occurs independent of valvular lesions. I shall now consider the 
enlargement of the heart when it is dependent upon valvular 
lesions. These are generally on the left side of the heart at the 
mitral and aortic orifice, (Fig. 41, 66). The valvular curtains 
are frequently thickened, or they become more or less rigid,with 
a calcareous deposit. *The valves may be diminished in thickness, 
and they are then liable to rupture. The different alterations of 
structure, of the valvular lesions, may be arranged into 1st, ob- 
structive lesions, which impede the flow of the blood, by produ- 
cing contraction of the orifices; 2d, regurgitating lesions, which 
interfere with the functions of the valves, allowing backward 
currents; 3d, lesions which both impede the flow, and allow 
backward currents; 4th, lesions which give rise to morbid sounds 
by roughening the surface over which the blood flows. The first 
symptoms incident to obstructive or regurgitating lesions, are ob- 
served in the respiratory region. The patient seldom complains 
of palpitation, since he has become accustomed to the gradual 
increase of the heart’s action. There is rarely much pain during 526 
COMMON SENSE MEDICAL ADVISEH. 
the progress of mitral lesions, and sooner or later, if life be pro- 
longed, dropsical effusion takes place in the areolar and serous 
tissues, and the limbs and body become greatly swollen. 
1011. Geiicral SEropsy, arising from mitral lesions, 
occurs after enlargement, by dilatation, of the right side of the 
heart, has taken place. Dropsy, caused by cardiac affection, 
happens in but a small proportion of cases of aortic lesions. 
Valvular lesions, associated with enlargement, are unfavorable. 
The symptoms which denote danger differ according to the 
location of the valvular lesions. 
1012. Pericarditis is inflammation of the membraneous 
sac which surrounds the heart, and may occur under two forms, 
viz: 1st, Acute; 2d, Chronic. The symptoms in acute pericar- 
ditis are made up from co-existing affections, and are frequently 
associated with articular rheumatism, Bright’s disease of the 
kidneys, or pleuritis. The intensity of the pain varies in different 
individuals. The action of the heart is increased, the pulse is 
quick, and vomiting sometimes takes place. When this disease 
is developed in the course of rheumatism, it is known as rheu- 
matic pericarditis, which is almost always associated with endo- 
carditis. In some cases acute pericarditis is very distressing, in 
others it is mild. The fatality is not due so much to the disease 
itself, as to co-existing affections. If it does not prove fatal, it 
sometimes becomes chronic. 
In chronic pericarditis pain is seldom present. The heart is 
more or less enlarged, its sounds are feeble, the first weaker than 
the following one, short and valvular. * 
1013. Endocarditis is inflammation of the lining mem- 
brane of the heart. The right cavities are seldom the seat of 
inflammation, and never without the left cavities are inflamed. 
In this disease the action of the heart is increased and manifest 
to the touch. The pulsations are rapid and strong, and generally 
irregular, unequal, and intermmittent. Endocarditis occurs in 
connection with acute articular rheumatism, and is often associ- 
ated with pericarditis. Pain about the region of the heart is not 
constant, and is rarely a prominent symptom, but when present, 
it is dull, not sharp as in pericarditis. In acute articular rheu- 
matism, not associated with pericarditis, it involves no 
immediate danger. It may, however, be the foundation for ORGANIC DISEASES OF THE HEART. 
527 
valvular lesions, which, after months or years, may cause serious 
consequences. 
1014. Angina Pectoris, otherwise termed Neuralgia 
of the Heart, might be included among the diseases of the nervous 
system, but as it is usually associated with a disorder of the 
action of the heart, it should properly be noticed in this connec- 
tion. This affection is usually characterized by severe pains 
about the sternum (breast bone), which radiate in different direc- 
tions. The pain differs in intensity, sometimes being very acute, 
at others assuming a milder form. The action of the heart is 
more or less disturbed. The beats are irregular, at times being 
strong, while again they are feeble. A feeling of numbness is 
experienced in those parts to which the pain penetrates. The 
countenance indicates suffering. These paroxysms usually con- 
tinue but a few minutes, although they sometimes last several 
hours. Persons suffering from angina pectoris are liable to 
sudden death. It is connected wdth ossification, or other morbid 
affections of the heart. Usually these paroxysms, if the life of 
the patient continues, become more and more frequent. This 
affection is contingent upon organic disease of the heart; indeed 
it has been questioned, if it ever occurs unless there be organic 
disease of some kind present. The danger is not to be measured 
by the intensity of the pain, but by the co-existing organic 
disease. Although it is not absolutely certain that it is present 
in all cases of angina pectoris, yet the exceptions are so rare 
that when the signs of organic disease cannot be detected, it may 
be inferred that angina is not the real affection, or that the 
existing lesions escape the observation. The patients suffering 
from this disease are, in the great majority of cases, of the male 
sex, and rarely under the age of forty. 
1015. Treatment. In the foregoing consideration of 
organic diseases of the heart, I have omitted to speak of their 
remedial management, for the obvious reason that non-profes- 
sional readers are unable to correctly distinguish between the 
various diseases of that vital organ; and it would therefore be 
useless for me to attempt to instruct them as to the medical 
treatment of the different cardiac affections. The specialist, 
whose sense of hearing is in daily training, by the constant prac- 
tice of auscultation 683), is alone competent to translate the 528 
COMMON SENSE MEDICAL ADVISER. 
abnormal sounds given off by the heart into signs of specific dis- 
eases of that organ. Many of the diseases affecting the heart, 
which but a few years since were regarded as incurable, are, in 
the light of more recent investigations and discoveries, very ame- 
nable to treatment. We now possess medicines that unmista- 
kably produce a specific effect upon the tissues of the heart, and, 
when skillfully applied, their employment is frequently attended 
by the most happy results. A very large number of well marked 
cases of organic disease of the heart have been permanently 
cured by the faculty of the World’s Dispensary, affording 
positive evidence that some forms of organic cardiac affections 
are quite as curable as most other chronic diseases. The remedies 
which have enabled me to accomplish such remarkable cures, are 
known to but a small part of the medical profession, and by many 
of those who do employ them for other purposes, are not known 
to possess properties Avhicli render them specific in diseases of the 
heart. For the special benefit, therefore, of my medical readers, 
and through them, that a blessing may be conferred in the relief 
of many sufferers, I cannot refrain from incidentally referring at 
this point, to two or three of those which I regard as among the 
most valuable remedies of recent discovery. As deserving of 
conspicuous mention is Collinsonin 565). Although all the 
serous tissues of the body are acted upon by this most valuable 
medicine, yet its most specific effect I have found to be upon the 
serous membrane lining the heart and covering its valves. Se- 
rous tissues, as my professional readers are aware, are ramified 
by small capillaries which, when diseased, allow exudations to 
ooze out and become organized, thereby producing thickening 
and enlargements, results which frequently follow inflammation 
of the peritoneum, pleura, endocardium (lining of the heart), 
pericardium (heart case), and other serous membranes. Collin- 
sonin produces absorption of the exuded matter and thus removes 
the abnormal condition. From its specific action upon serous 
tissues, physicians will readily understand how they can utilize 
this valuable agent in many of the diseases affecting the serous 
tissues, not only of the heart, but of other parts. To illustrate 
the positive effect produced by this medicine, I will mention the 
case of Mrs. B., a lady aged about thirty-five, who was so much 
oppressed with valvular disease of the heart that she could not DISEASES AFFECTING THE DIGESTIVE ORGANS. 
529 
walk up stairs or otherwise exert herself actively,without suffer- 
ing severely. I administered collinsonin and she gradually and 
fully recovered from the disease. Collinsonin is not only effica- 
cious in organic disease of the heart, but from a controlling 
influence which it exerts through the pneumogastric nerve (*[f 119, 
Fig. 59), which presides over the action of the heart, it is also a 
sovereign remedy in functional diseases of that organ. 
1016. Cactus Grandiflorus (Night-Blooming Cereus), is an- 
other invaluable agent which I employ in treating these formid- 
able affections. It is very little known, however, to the medical 
profession as a remedy for such disorders. By a large experience 
in the use of this agent, I am satisfied that it increases the nutri- 
tion of the heart and thus strengthens it in the performance of 
its functions. Hence the happy results following its employment 
in atrophy of the heart. 
Veratrum Viride 597), in very small doses, is also a specific 
heart tonic. 
My Golden Medical Discovery also contains an ingredient that 
exeits a very manifest influence in diseases of the serous tissues 
of the heart, and also in those where a heart tonic is required. 
Feelings of pressure and weight in the region of the heart, diffi- 
cult breathing, palpitation and the fear of impending danger 
which they occasion, are promptly removed by the use of this 
compound. 
DISEASES AFFECTING THE DIGESTIVE SYSTEM. 
1017. Existence implies an organism which is capable of 
manifesting life. To increase the growth of organized existence, 
and furnish it with the conditions of its vital manifestations, food 
is essential. This must be digested, absorbed, mysteriously ani- 
mated, and become a part of the structure, which, by various 
organs, separates the equivalents of its own being into higher 
and subtler elements; a process which yields also a remainder of 
waste and decay. This transformation of food into life must be a 
constant procedure,and it brings into active co-operation many dis- 
tinctly separate organs,* which constitute the digestive system,and 
are liable to become either functionally or structurally diseased. 
* The important organs of digestion are concisely stated in *[[ 44, together with a 
description of the anatomy and physiology of each. 530 
COMMON SENSE MEDICAL ADVISEE. 
SORE MOUTH. (Stomatitis.^ 
1018. Stomatitis—inflammation of the mucous membrane of 
the mouth—may include the entire surface of the gums, tongue, 
and cheeks, or appear only in spots. Vesicles are formed, having 
swollen edges and a white or yellow center, which finally ulcer- 
ate. When mild, the affection is confined to these parts. 
1019. If the inflammation be acute, the mouth is dry and 
parched, or, as is more frequently the case, the flow of saliva is 
abundant and acrid, and, when swallowed, irritates the stomach 
and bowels, producing fever, diarrhoea, griping pains and flatu- 
lence. The tongue is either coated white, or red and glossy, 
and the sense of taste is considerably impaired. Digestion and 
nutrition are then disturbed and the patient rapidly emaciates. 
1020. TSiritsli, or Canker, is that form of stomatitis 
in which white ulcers locate on the inner side of the upper lip, 
the tongue or roof of the mouth; the irritation which they 
cause, not only interferes with eating, but produces fever, 
together with the symptoms previously mentioned. 
1021. Aptflc©, or follicular inflammation, is distinguished 
by very painful little ulcers, single or in clusters, scattered over 
the surface of the tongue and lining of the mouth. Sometimes it 
is complicated with little lumps in the tongue. These form 
ulcers, and denote scrofulous inflammation. Fissures and cracks 
in the tongue indicate derangement of the stomach. 
1022. Til© Causes of stomatitis, in nursing infants, are 
unhealthy milk, or effete matter, which, for lack of proper care 
and cleanliness, accumulates upon the nipple. In older children, 
improper diet, irritants, as mercurial medication, debility of the 
digestive functions, or hereditary syphilitic taint, disorder the 
blood and induce local inflammation. 
1023. Treatment, locally, use a wash of golden seal, 
made sweet with maple-sugar, and slightly alkaline with borax 
or salseratus. Also use a very weak alkaline tea, or one of 
slippery-elm flour, to obviate the acridity of the secretions. If 
the sores do not heal, constitutional treatment may be required, 
as the use of the Golden Medical Discovery. It is proper to 
consult with the family physician, if the .sore mouth resists all 
these remedial measures. NURSING SORE MOUTH. 
531 
1024. During the period of lactation (nursing) and sometimes 
in the latter month of pregnancy women are liable to a peculiar 
variety of sore mouth. The soreness is sometimes so great that, 
although the appetite may be ravenous, the patient cannot eat. 
When this condition extends to the stomach and bowels, symp- 
toms of a very grave character appeal-, and the disease, by 
interfering with the process of nutrition, causes emaciation and 
debility, and in extreme cases, death. It is a strange affection, 
nearly always disappearing upon weaning the child, though this 
course is not absolutely necessary. It appears to depend upon 
a hepatic, or gastric derangement, in connection with a vitiated 
condition of the blood, though how this is brought about is 
unknown. 
NURSING SORE MOUTH. (Stomatitis Materna.) 
1025. Symptoms. The disease sometimes comes on sud- 
denly, at othei’S more slowly. The fact that the woman is either 
pregnant or nursing, is of importance in distinguishing it. At 
first there is a severe, scalding sensation of the tongue, mouth 
and fauces, with pain, which is sometimes intense. The color of 
the tongue is often pink, or a light red, while the mouth is gen- 
erally of a deeper hue. This stinging, biting sensation is accom- 
panied by a profuse watery discharge from the mouth, which 
seems extremely hot and acrid, causing excoriation whenever it 
conies in contact with the face or chin. The appetite is good, 
sometimes ravenous, but food or drinks, except of the blandest 
character, occasion such intense pain that the patient avoids 
their use. Ulceration occurs after a little time. The bowels are 
generally constipated, but when the disease extends to the stom- 
ach or intestines, diarrhoea occurs. There is generally ansemia, 
debility and impairment of the vital powers. 
1026. Treatment. The indications for treatment in this 
affection will be (1) to overcome the vitiated condition of the 
blood, and (2) to sustain the vital powers. The remedies for 
these purposes will be alteratives, antiseptics and tonics. For 
the first indication, give my Golden Medical Discovery, the value 
of which may be greatly enhanced by adding one-half ounce of 
the fluid extract of baptisia 506) to each bottle, when the 
dose of medicine as modified, will be a teaspoonful four times a 532 
COMMON SENSE MEDICAL ADVISEE. 
day. Chlorate of potash,— half an ounce in a pint of water — 
used as a wash and gargle, will be of great value. A teaspoonful 
of the same may be swallowed several times a day, and will not 
interfere with other medicines. To fulfill the second indication, 
the muriated tincture of iron 618), in five to ten drop doses, 
diluted with water, may be taken three or four times daily. 
Quinine 496), in one or two grain doses, may be given with 
the iron if the debility is extreme. When there is great acidity 
of the stomach, which will be known by heart-bum and distress 
in that organ, saloeratus 475) may be taken in water, to neutral- 
ize it, but should not be drank within an hour of the time for 
taking other medicines. If constipation prevails use my Purga- 
tive Pellets. This course of treatment, well carried out, will 
seldom fail in effecting a perfect cure,without weaning the child, 
yet the latter eourse will sometimes become advisable and greatly 
promote the recovery of the patient. Should the treatment 
advised not produce the desired result, a skillful physician’s 
services should be secured, as he may, in individual cases, dis- 
tinguish farther important indications which will enable him to 
modify the treatment to advantage. 
DISEASES OF THE STOMACH. 
1027. If the reader will turn to 51, he will find a descrip- 
tion of the anatomy of this important organ, which, by its hidden 
power, inaugurates the initial changes which finally convert 
food into a part of ourselves. It has been remarked, “The 
stomach is the distinguishing part between an animal and a vege- 
table; for we do not know any vegetable that has a stomach, nor 
any animal without one.” If Dr. John Hunter’s observations 
had been more extended, he might have found plants that would 
catch, dissolve and digest, flies and insects, proving that the 
function of digestion in some plants is supplemental, and resem- 
bles that of animals. The sarracenia, nepenthes, drosera, and 
other plants, are furnished with various kinds of traps and 
snares for the unwary insects which they catch and digest. 
1028. There is an intimate connection between the stomach 
and brain. The former is the seat of universal stimulus and 
irritability, as much as the latter is of sensibility. Their intimate 
relation is illustrated by the fact that some cannot hear of an STRUCTURAL DISEASES OE THE STOMACH. 
533 
accident, or of any distressing circumstance, without experiencing 
sickness or vomiting. And it is equally strange that an injury 
of the tendons and ligaments, which have little sensibility, affects 
the stomach more than an injury of the muscles, which possess 
much greater susceptibility to pain. 
STRUCTURAL DISEASES OF THE STOMACH. 
1029. Those affections which implicate the coats of the 
stomach are designated as structural. The stomach is liable to 
become the seat of a Gastric Ulcer, the symptoms of which 
are similar to those of acute gastritis. If small, it is of a round 
or oval form, and liable to eat through the coats of the stomach, 
when it is known as the perforating ulcer. The pain is of a 
burning, gnawing character, experienced especially after food 
has been taken. Vomiting is a common symptom and the mat- 
ters emitted are tinged with blood. 
1030. Carcinoma. Cancer of the stomach does not 
occur so frequently as gastric ulcer, and may be distinguished 
from it by a lancinating pain, and tenderness over the epigas- 
trium. Vomiting occurs in both affections, and in the latter 
stages of cancer, food, blood, and pus are so mingled as to 
resemble coffee grounds. It can be distinguished from dyspepsia, 
because in the latter affection there is no vomiting of blood or 
pus, nor so great emaciation or pallor. 
1031. Dilatation. Dilatation of the stomach may be 
caused by a closing of the pyloric orifice (Fig. 28), on account 
of the thickening of its walls or the intervention of some foreign 
substance. 
Symptoms. Vomiting at intervals, when a great amount 
of imperfectly digested aliment, which emits a putrescent odor, 
is ejected. The stomach is full and prominent, and pressure 
upon it causes the liquids to fluctuate and give out a splashing 
sound. Generally the appetite is not impaired. 
1032. Softening of the mucous coat of the 
stomach is a rare affection and is not attended by inflammation. 
It may be distinguished from gastritis by the absence of all 
putrescent odor when vomiting occurs, and by an inability to 
retain solids upon the stomach. It is very liable to involve 
other structures of the stomach, and when it affects children, 534 
COMMON SENSE MEDICAL ADVISEE. 
it gives rise to symptoms of cholera infantum. In older per- 
sons, death may occur from starvation, because of the inability 
to retain solid food upon the stomach. 
1033. Induration. The walls of the stomach may 
thicken and harden in consequence of a morbid deposit of fibroid 
substance under the mucous tissues. This is the result of 
chronic inflammation, generally caused by the use of ardent 
spirits. The use of such beverages incapacitates the stomach 
for churning the food and the patient becomes dyspeptic. It 
rarely occurs in persons under forty years of age, and is an 
affection difficult to diagnose. The danger depends upon the 
extent of the disease and the severity of its symptoms. The 
cause of death in such cases is indigestion and consequent 
exhaustion. 
1034. Treatment. In gastric ulcer, regulate the diet and 
use nutritive food, such as can best be retained by the stomach. 
Milk and vegetables are adapted to this purpose. A drink of 
slippery-elm, or of lime-water and milk should be used, and if 
there be great thirst, small pieces of ice may be given. Mut- 
ton broth is nourishing as well as unirritating, and injections 
of it sustain the strength. The treatment of cancer is only 
palliative, and should have reference to the comfort of the 
patient and the prolongation of life. The hygienic management 
consists in furnishing a bland, nutritious diet, keeping the skin 
clean, and using such remedies as relieve pain and gastric irrita- 
bility as the trisnitrate of bismuth and anodynes. In dilatation 
of the stomach the treatment consists in regulating the diet 
and using tonic remedies. In softening of the stomach, the 
careful adaptation of the food and use of antiseptics is recom- 
mended. In induration, the treatment must be palliative; relieve 
the irritation, abstain from stimulants and regulate the diet. 
All the above affections may be benefited by the use of those 
agents whicli increase the digestive powers, as pepsin, ptyalin and 
those acids found in the gastric juice. These agents are digestive 
solvents and prepare food for undergoing vital changes. All 
the minute symptoms of such diseases should be reported to the 
physician that he may be able to furnish appropriate remedies 
and digestive fluids which will relieve the patient, prolong life 
and sometimes cure the disease. INFLAMMATION OF THE STOMACH. 
535 
INFLAMMATION OF THE STOMACH. (Gastritis.) 
1035. Gastritis is generally defined as an inflammation of the 
mucous membrane of the stomach. The cellular, muscular, and 
serous tissues are all liable to be more or less affected. Gastritis 
may be either acute or chronic. Either form is a distinct modi- 
fication of disease, manifesting peculiar symptoms and requiring 
special remedies. 
1036. Acute Gastritis generally occurs as a result or accom- 
paniment of other diseases. It is an occasional feature in scarla- 
tina, serious cases of bilious fever, and in cutaneous affections of 
every description. The mucous membrane of the stomach is a 
continuation of the skin, and is placed in intimate communication 
with all the vital organs, by means of the solar plexus (1 124, 
Fig. 60); hence this sympathy between the stomach and skin, 
and the morbid condition of the stomach occasioned by the 
disease of other organs. * 
1037. The Early Symptoms of acute gastritis are a 
burning sensation in the stomach, accompanied by nausea and 
frequent vomiting. The respiratory movements are rapid and 
shallow, the pulse is hard and short, and as the disease pro- 
gresses, becomes small, frequent, and thready. The tongue 
usually retains its natural appearance, but is sometimes dry and 
tinged with a vivid scarlet at the tip and edges. Intense thirst 
and hiccough are occasional symptoms. The facial expression 
is haggard, and indicative of the most intense suffering. The 
stomach will not retain the mildest liquids. In the early stages 
of the disease, the ejections consist of chyme and mucus, streaked 
with blood. As it progresses, the vomiting becomes a sort of 
regurgitation, the contents of the stomach being ejected without 
any apparent nausea or effort. The ejections then consist of a 
dark-colored granular matter, resembling what is known in 
yellow fever as black-vomit. 
1038. Causes. Formerly it was supposed that this was a 
very common disorder, and the term “acute gastritis” was 
applied to every development of symptomatic fever. But late 
clinical and pathological investigations clearly indicate that acute 
gastritis is of quite rare occurrence. It may he caused by the 
excessive and habitual use of alcoholic drinks, especially if taken 536 
COMMON SENSE MEDICAL ADVISER. 
without food, by copious draughts of cold water, or by intense 
emotions. But its general cause is the ingestion of irritating and 
corrosive poisons. 
Where the former causes are known not to exist, the presence 
of poison should always he suspected. As it frequently becomes 
a matter of legal investigation, it is very important that the 
practitioner should he able to determine the real origin. If 
caused by poison, the disease will be very suddenly developed, 
the patient complaining of a very intense burning sensation in the 
throat and the lining membrane of the mouth, which will gen- 
erally show the action of the poison. A diarrhoea is also more 
apt to accompany the disease. If inorganic or vegetable poisons 
are the known or suspected irritants,the appropriate antidotes 
should be promptly administered. For a list of the principal 
poisons and their antidotes, with practical suggestions for treat- 
ment, the reader is referred to the article in this volume, on 
Accidents and Emergeifcies. 
1039. Treatment. This inflammation needs to he 
allayed, and a tea made of peach-tree leaves 599) will he 
found to he very serviceable. Small pieces of ice, swallowed, 
will allay the thirst and vomiting, and a mucilage of slippery-elm, 
made from superfine elm flour, is very soothing to the inflamed 
mucous membrane. It is an important disease, and its manage- 
ment should be entrusted to a skillful physician. 
CHRONIC INFLAMMATION OF THE STOMACH. 
1040. Chronic Gastritis is often mistaken for dyspepsia 
and gastralgia. It is very necessary to discriminate between 
these diseases, as the appropriate remedies for the latter will only 
aggravate and augment the former. 
A chronic inflammation of the stomach is a very common dis- 
order, and has many phases, blit the term chronic gastritis is 
applied only to that species of inflammation occasioned and 
accompanied by irritation. It is seldom a sequence of the acute 
form. It may exist many years and the patient still remain in 
apparent good health. 
1041. The Symptoms of chronic gastritis are various 
and equivocal. Among those which are prominent and universal 
we may mention an irregular appetite. At times it is voracious, NEUEAXGIA OF THE STOMACH. 
537 
and the patient will consume every available article of diet, 
while at others he will experience nausea and disgust at food. 
Even when very hungry, one mouthful of food will sometimes 
produce satiety and cause vomiting. The appearance of the 
tongue is variable,— sometimes natural, at others thickly coated. 
The desire for drink is capricious, varying from intense thirst to 
indifference. Another prominent symptom is a sense of heaviness 
and heat in the epigastric region, after partaking of food. Often 
a small quantity, as a teaspoonful of milk, will produce a sensa- 
tion of weight, as of a heavy ball lying at the pit of the stomach. 
This symptom is frequently accompanied by a frontal headache, 
with a small and wiry pulse. Dull or shooting pains are experi- 
enced, and the patient becomes weary, melancholy and emaciated. 
1042. Causes. The general cause of chronic gastritis is 
excess in eating or drinking. Great mental excitement predis- 
poses the system to this affection. Occasionally it is a sequence 
of febrile diseases, as scarlatina, typhoid fever, etc. In some 
families there is a constitutional tendency to its development. 
1043. Treatment. All medicines which tend to augment 
the irritation of the stomach, should be studiously avoided. The 
bowels should be kept regular, and the skin clean by frequent 
bathing. Stimulants of all kinds must be avoided. As a prin- 
cipal article of diet, unless the disease be caused by the use of 
alcoholic drinks, I would recommend rare cooked beef, as it is 
both nutritious and easily digested. In a word, the food should 
not contain much liquid, but should be mild and nourishing, and 
taken in moderate quantities. If these precautions are observed, 
nature will sometimes effect a cure. Other suggestions appli- 
cable to its domestic management, may be found under the hy- 
gienic and remedial treatment of dyspepsia, to which I refer 
the general reader. 
NEURALGIA OF THE STOMACH. (Gastkalgia.) 
1044. Gastralgia may be defined as a neuralgic affection of 
the stomach, unaccompanied by inflammation. It is often mis- 
taken for chronic gastritis, although there is a marked difference 
in the symptoms. 
1045. A Prominent Symptom ot* Ctastralgia 
is a paroxysmal Dain, radiating from the epigastric region, to all 538 
COMMON SENSE MEDICAL ADVISEE. 
parts of the thoracic cavity. The pain is lessened by walking, 
lying on the left side, or by gentle pressure, and usually abates 
after eating, but is renewed in a few hours. The patient then 
experiences a sense of heaviness at the pit of the stomach, 
nausea and frequent salty'eructations. The tongue is white, 
the appetite variable and there is no desire for liquids. The 
sleep is usually refreshing, and when not suffering from acute 
pain, the patient is apparently well. 
The Distinguishing symptom of this disease is a feeling of 
despondency, often amounting to an utter disgust of life, or 
it may be, a morbid fear of death. 
1046. An effectual way of discriminating between gastral- 
gia and chronic gastritis is by the administration of a diffusible 
stimulant. If gastritis be the disorder, the pain will be aug- 
mented; if gastralgia, it will be relieved. 
1047. Cause. The cause of gastralgia is a local or sympa- 
thetic irritation of the nerves distributed to the stomach. 
1048. Treatment. The pain of gastralgia is sometimes 
allayed lby using half a teaspoonful of subcarbonate of bismuth, 
and repeating the dose, if the attack be not relieved. Or take 
twenty grains of quinine, combined with one drachm of prussiate 
of iron, and divide it into ten powders, and administer a powder 
every three hours until the pain is completely arrested. Tem- 
porary relief may be experienced by using one-quarter of a grain 
of morphine, or two or three drops of chloroform in a tea- 
spoonful of glycerine, slightly diluted, and take it for one dose. 
Then follow with constitutional ti’eatment. One of the most 
effective remedies for this purpose is that invigorating tonic 
and alterative, the Golden Medical Discovery. The patient 
must be careful of his diet, and not overindulge himself in 
food, which should not only be of a nutritious kind, but easy of 
digestion. The general health, as relates to regular habits, 
cleanliness, suitable clothing and bodily -warmth, exercise and 
rest, must not be neglected. Sometimes it proves to be a linger- 
ing chronic complaint, which can be best overcome by pursuing 
a steady, even-handed course of hygienic treatment. Every 
thing calculated to promote the tone of the digestive organs, and 
improve the functions of the system generally, may be considered 
advantageous in remedying this neuralgic affection. DYSPEPSIA. 
539 
DYSPEPSIA. 
1049. It is generally conceded that a multitude of human ail- 
ments arise from indigestion, and in its various forms it taxes the 
skill of the physician to prescribe the proper remedy. It is un- 
deniable that the closest intimacy exists between happiness and 
good digestion. A healthy digestion aids materially in making a 
cheerful spirit, and the “ feast of reason and flow of soul ” is due 
as much to the functional integrity of the stomach as to a strong 
and generous mental organization. 
1050. Dr. Johnson severely said: “ Every man is a rascal as 
soon as he is sick” If people did not treat each other as though 
this was true, there would be neither cuteness nor severity in the 
remark. All are conscious that morbid acidity of the stomach 
roils the disposition and excites tart sayings. And likewise, an 
irritable temper and suddenly aroused passions will not only turn 
sour the sweetest stomach, but even poison the secretions 209). 
Anxiety, excitability, fear and irritability, are disturbances of 
those propensities which cause the perversion of physiological 
processes 168). To sweeten and gladden the mind by anima- 
ting the emotive powers, tends to correct morbid acidity of the 
stomach. 
1051. Every intelligent, observing person, as well as the 
wisest philosopher, knows that a large proportion of dyspepsia 
cases originate in, and are perpetuated by, a morbid activity of 
the basilar faculties. If otherwise, then why is it that persons of 
a certain mental constitution are so prone to dyspepsia. Mental 
disquietude is only an indication of the morbid activity of these 
semi-animal faculties, or else of their natural preponderance, 
which, when united with imagination, are prolific of visionary 
troubles. We see some people who are constantly anxious, un- 
fortunate, discouraged, when they are all this time prospering 
finely; to gratify these low faculties they have to actually borrow 
affliction. If they don’t fret about their own misfortunes they 
will generously dwell upon the perplexities of others. No wonder 
they are afflicted with dyspepsia and increase their morbid sensi- 
bility by closely watching every symptom of indigestion.* 
* Some people digest their food well, yet are always complaining as though they 
were sufferers from morbid sensibility of the stomach; while there are others whose 
digestion is imperfectly done, but who never complain. 540 
COMMON SENSE MEDICAL ADVISER. 
1052. The general truth of these propositions will be appre- 
ciated by contrasting these languid, lean, lank, nervous victims 
of indigestion and domestic infelicity—confirmed dyspeptics— 
with the fresh, vigorous vitality of the opposite class, wdiose 
rotund figures, bright eyes, dimpled cheeks, buoyant spirits, 
hopeful, sparkling thoughts, and graceful physical movements, 
so replete with ease and elegance—the poetry of motion,—all 
indicate the soundness and perfection of digestion. The latter 
make 
“ The glad circle round them yield their souls 
To festive mirth and wit that knows no gall.” 
1053. The slightest functional disturbance of the stomach 
will derange, more or less, all the succeeding operations of 
alimentation, tending to the vitiation and impairment of the 
delicately susceptible vital processes of nutrition. Dyspepsia 
may commence and proceed so insidiously as not to excite the 
suspicion of friends, although the patient generally desires active 
treatment, such as cathartics, emetics, and medicines to act upon 
the liver. When the disease becomes confirmed, it presents us 
some of the following symptoms: weight, uneasiness and fullness 
in the region of the stomach, attended by impatience, irritability, 
peevishness, sluggishness, anxiety, or melancholy; there is im- 
pairment of the appetite and taste, also sourness, flatulence, and 
perhaps frequent attacks of colic, loss of hope, courage, ambition, 
and increasing apathy, drowsiness, and frightful dreams, are 
symptoms common to the different stages of this disease. There 
are then the accompanying symptoms of a coated tongue, bitter 
taste of the mouth, offensive eructations, scalding of the throat 
from regurgitation, offensive breath, sick headache, giddiness, 
disturbed sleep, sallow countenance, heart-burn, morbid craving 
after food, constant anxiety and apprehension, fancied impo- 
tency, and frequent change of mind; they-imagine that they 
want medicines to work upon the liver, desire active treatment, 
are endlessly experimenting in diet, daily rehearse their symp- 
toms, and are morbidly sensitive; if there be doubt in their 
minds as to whether they are genuine dyspeptics, they ask the 
opinion of a physician in whom they have perfect confidence, 
and when it is candidly given they will, ordinarily, be satisfied 
with it for fifteen minutes; but for any greater lapse of time, it DYSPEPSIA. 
541 
will be less and less conclusive, more and still more unsatisfactory. 
This unbelieving state of the mind clearly indicates that an irrita- 
tion of the stomach excites the animal faculties rather than the 
emotional. 
1054. Causes. Overtasking the system, overloading the 
stomach, use of improper food, as stale vegetables and meats, 
unripe fruits, indigestible articles, etc., improperly prepared food, 
irregular meals, disorderly habits, the use of alcoholic stimulus, 
overtasking the mind, loss of sleep, self-abuse, irritable temper, 
unhappy frame of mind, inordinate ambition leading to efforts 
disproportioned to the physical strength, are all circumstances 
which give rise to indigestion. If the functions performed by 
the skin are embarrassed, by cold, tight clothing, or lack of 
cleanliness, the nutritive changes cannot properly take place 
throughout the body, and consequently the digestive functions 
are embarrassed, as the revolutions of a water-wheel are im- 
peded by the “ backset ” of the water. When food is not duly 
masticated, it is not properly salivated with the alkaline fluids 
of the glands of the mouth, and is not prepared for digestion 
by the acids of the stomach. 
1055. This principle holds true, that whatever diminishes the 
general strength, impairs the health, or encroaches upon the 
functions of life, also hinders the perfect solution of food and 
disturbs in a measure the function of digestion. Whatever dim- 
inishes the normal amount of the alkaline secretions of the sali- 
vary glands, and of the gastric juice, or perverts their quality, 
deteriorates their solvent properties and is a cause of dyspepsia. 
This must be borne in mind in selecting remedies. 
1056. After the solution of food, and before its absorption 
and appropriation as chyle, it is quickened into newness of life 
in the sublime alchemy of vital transformation, by the nutritive 
process of catalysis. By it, dead animal or vegetable protoplasm 
is magically endowed with the property of life, indispensable for 
the regeneration of our bodily tissues, and to fit and continue 
them in their inscrutable sphere, under the dominion of sensation 
and will. To comprehend this function is to understand the 
mystery of nutrition, for by the presence of certain animated 
cells or living material, a vivifying metamorphosis, necessary to 
our renewal and life, takes place, which change is everywhere 542 
COMMON SENSE MEDICAL ADVISEE. 
known as vital catalysis. Life is established and perpetuated by 
life, and without such a process there can be no nutrition. The 
chemical part of digestion is dissolving food and reducing it to a 
soft, pulpy, cream-like, plastic fluid, but the vitalizing of this 
mass, or a certain portion of it, is the result of catalytic action,— 
an organic exercise or function, which we do not, as yet, under- 
stand. 
1057. In thus referring to this wonderful physiological pro- 
cess, I do it in part to show why some kinds of restorative 
medicines, which alter, counteract or destroy poisons in the 
blood, or even neutralize them, are called catalytic remedies. 
The very fact that they work out a peculiar and converting or 
transforming change in the blood, and arrest the morbid tenden- 
cies to disease, shows that their remedial function entitles them 
to such a significant name. A remedial catalytic action is one 
that destroys original or acquired poison, and such remedies are 
given, not to supply a want in the system, but to strike at the 
root of an evil. In this sense they are recognized as the surest 
and most potent class of remedies employed in the treatment of 
all diseases of the blood, and explains why I continue to offer in 
so many morbid affections, my Golden Medical Discovery as 
being efficacious, ample and adequate to meet the emergencies. 
1058. Treatment. Hygienic treatment consists in the 
regulation of the daily habits, right selection and preparation 
of food, cultivation of cheerfulness, diverting the mind, and 
keeping the body clean. We cannot give particular directions 
in relation to the kind of diet, as there are no undeviating rules 
for hygienic guidance. The directions applicable to the condi- 
tion of one patient are not suited to those of another. In 
debility of the stomach, animal food is preferable on one ac- 
count, because more easily digested. And sometimes alkalies 
may be given with happy effect, when there seems to be excess 
of acid. 
1059. In some cases, the digestive fluids are weak, the mouth 
is dry and its alkaline secretions are lacking, and fermentation 
results, giving rise to flatulence and belching. An antiseptic 
500), which may he prepared by mixing a teaspoonful of 
muriatic acid with four ounces of water, and of which a tea- 
spoonful may be taken after each meal, will prove beneficial in DYSPEPSIA. 
543 
checking the fermentation. The addition of one or two drops, 
of a mixture of one part of carbolic acid and six of glycerine, 
to the above solution of muriatic acid, improves it. When the 
alkaline secretions of the mouth are deficient, ptyaline has been 
employed with obvious advantage, preventing the occurrence of 
fermentation. 
1060. Acidity of the stomach and attending irritation may 
be allayed by the following mixture: calcined magnesia, one 
drachm, refined sugar, one drachm, subnitrate of bismuth, one- 
half drachm, oil of cajuput, ten drops. Dose, half a teaspoon- 
ful, an hour after a meal. 
1061. It is not easy, many times, to prevent the patient from 
overdistending the stomach, and thus impairing the tone of the 
muscular coats and hindering the complete reduction of the food 
to pulp. Close attention and persevering trial, however, is 
necessary, for in this particular many dyspeptics exhibit mono- 
mania. It is no use to employ remedies unless this gross habit 
be abandoned. 
1062. In consequence of debilty, overdoing, anxiety, chronic 
inflammation of the stomach, etc., there is not a due secretion, 
in quantity or quality, of digestive solvents, and it matters not 
whether it he a deficiency of salivary fluids, or of the gastric 
juice, or of both, the result is, indigestion. Remedial treatment 
then becomes chemical as well as medicinal, and this query is 
suggested to the physician, viz: what important agent is lack- 
ing? Is it ptyaline, the digestive principle of the saliva, which 
separates and dissolves the nutritious portions of vegetable sub- 
stances, and which is unquestionably one of the essential agents 
in digestion ? If it is, how few are qualified by experience to 
determine the condition, or have the remedy properly prepared 
for administration ? Is it pepsin, one of the agents in gastric 
juice, which converts albumen, fibrine, casseine, etc., into peptone, 
that is wanting, or is there a lack of pancreatine, a secretion of 
the pancreas, which prepares oily substances for assimilation, as 
well as assists in digestion of food? If so, has the physician 
the remedial agents properly prepared, combined and ready for 
prescription ? The specialist, having more cases of dyspepsia to 
treat than the general practitioner, is more likely to have the 
latest and most approved remedies applicable to loss of appetite, 544 
COMMOST SEXSE MEDICAL ADVISER. 
indigestion, impoverished blood, faulty assimilation, and for all 
diseases arising from imperfect nutrition. In ordinary practice, 
the physician’s time is divided in his consideration of acute, 
chronic, surgical and obstetrical cases; in fact, much of it is 
occupied in riding to reach his patients. His attention is con- 
tinually diverted from one class of cases to another, effectually 
preventing investigation in any special direction. His patronage 
does not warrant him in the outlay of time required for the in- 
vestigation of particular diseases and the expense necessary to 
obtain the latest and best remedial facilities for their treatment. 
In the multiplicity of his cares and arduous duties by night 
and by day, obstinate chronic cases become an annoyance to 
him, and whenever he can be otherwise professionally employed, 
he avoids them, disliking to undertake their treatment. 
1063. But with plenty of time for scientific investigation, 
ample facilities to meet the demands upon his skill, and each 
succeeding case presenting some new phase, the treatment be- 
comes a matter of absorbing interest to the specialist, and each 
success inspires greater confidence. To illustrate: I not only 
use in these cases of indigestion, solvent remedies, like pepsin, 
which act only upon food of a plastic nature, but a variety of 
other agents of more recent discovery, which possess the power 
of dissolving all aliment used by mankind. 
1064. The chemistry of digestion and of life is "becoming 
better understood. Any of the free acids may serve to dissolve 
a precipitated phosphate; but it is only the investigating thera- 
peutist and experienced practitioner who understands which of 
them is the most and which is the least efficacious. Alkalies may 
dissolve a lithic deposit, but who, unless he is an experienced 
physician, can detect the fault of nutrition that leads to their 
formation, or rightly interpret the symptoms indicating it? 
These simple illustrations of the complications that attend dys- 
pepsia are mentioned merely to show that they must be antici- 
pated, foreseen, and embraced within the scope and curative 
aims of the physician. 
1065. For these and many similar reasons, when simple 
domestic management fails, the author is constrained to frankly 
advise the employment of those skilled in the treatment of these 
affections, and familiar with all their symptoms and signs, and DYSPEPSIA. 
545 
who also have remedies applicable to all the various phases of a 
disorder so fearfully prevalent. 
1066. The number of cases of dyspeptic invalids treated by 
the Faculty at the World’s Dyspensary, within the past few 
years, as may be proved from the records of this institution, is so 
large as scarcely to be credited by those unacquainted with the 
prevalence of this disease, without such indisputable evidence. 
In consequence of these almost innumerable applications, I 
have taken unusual pains to investigate their causes, and have 
spared no expense in pi’oviding for treatment the latest and most 
approved digestive solvents and stomachic tonics, which invig- 
orate the mucous membrane of the stomach and materially assist 
in reducing the food to a liquid condition. Some of these, with- 
out being purgative, augment the alvine evacuations and increase 
the activity of the liver, two very important indications which 
must be fulfilled incidentally by remedies without causing any 
real depression, even with feeble and debilitated patients. The 
recent important discoveries made in obtaining the active prin- 
ciples of our indigenous plants, opened the way to the use of a 
few of the most important of these remedial agents, hitherto 
almost wholly unknown to the medical profession, and the 
encouraging results attending my practice has amply justified 
and richly repaid me, both for the investigation and originality 
in my treatment of this chronic malady. 
CASES TREATED. 
1067. The correct diagnosis by symptoms, and the discrim- 
ination as to the actual morbid conditions which perpetuate this 
functional difficulty, have not unfrequently required a chemical 
analysis of the patient’s urine, unless these could be determined 
by its microscopical examination; and so various are the morbid 
conditions thus revealed and recognized, so dissimilar the treat- 
ment required, that the general reader can hardly derive much 
benefit from perusing reports concerning their successful man- 
agement. For this reason I will not devote these pages to such 
statements; nor will I publish any of the numerous testimonials 
which I have in my possession and which have been gratefully 
and spontaneously offered me as undeniable evidence of my 
success. 546 
COMMON SENSE MEDICAL ADVISEE. 
INFLAMMATION OF THE BOWELS. (Enteritis.) 
1068. When the mucous membrane of the small intestine be- 
comes inflamed, the disease is termed enteritis, and it sometimes 
extends to the large intestine. It is known in two forms, viz: 
Acute and Chronic. 
1069. Acute Enteritis occurs more frequently during the in- 
fantile period of life than afterwards. 
1070. The Symptoms are pain and tenderness of the 
abdomen, diarrhoea,vomiting and fever. There is dull, aching pain 
referred to the umbilical region, and the dejections are mucous 
and gelatinous, or watery and acrid, producing a burning sensa- 
tion. 
1071. The Causes, commonly are colds, fatigue, de- 
bility drastic purgatives, indigestible food, or any acrid sub- 
stance. It is most likely to be confounded Avith inflammation of 
the peritoneum (the serous membrane which invests the bowels), 
but may be distinguished from it by diarrhoea and absence of 
general prostration. It may be distinguished from colic by 
pressure,which relieves the pain,while in peritonitis it increases it. 
1072. Chronic, Enteritis which is usually the result of the 
acute form, is more limited in its morbid operation upon the 
mucous surface of the intestine, frequently affecting the glands 
and follicles, and hence has been termed glandular or follicular 
enteritis. 
1073. The Symptoms, when the disease has been of 
long duration, are languor and weakness, sallowness and harsh- 
ness of the skin, coldness of the hands and feet, dryness of the 
lips and mouth, irritability, headache, weak pulse, impaired ap- 
petite, emaciation and night-sweats. There is also great sensi- 
tiveness and irritability of the stomach, indicated by nausea and 
vomiting, for the patient not only ejects whatever food and 
drink he swallows, but has retchings when the stomach is per- 
fectly empty. 
1074. Causes. Chronic enteritis is produced by the same 
agencies as those which excite the acute form of this disease, 
and frequently is the sequel of such an attack. In a scrofulous 
diathesis 806), where there is some evidence of eruptive dis- 
order, a suppression of the perspiration and the disappearance PERITONITIS. 
547 
of cutaneous eruptions may be the occasion of derangement of 
the stomach, resulting in indigestion and irritability, followed 
by chronic inflammation of the small intestine, fetid discharges, 
and emaciation. It may be caused by errors in diet, exposure to 
cold, insufficient protection of the surface from sudden climatic 
changes, etc. 
Prognosis. When this disease attacks adult persons, it is by 
no means dangerous, unless the patient is weak and scrofulous, 
in which case it may indicate the existence of tubercular disease. 
The patient then wastes away, the pulse becomes feeble, and 
prostration and death follow. 
1075. Treatment. In the early stages of the acute form, 
give a mild evacuant, to open the bowels and free them from 
any offending or irritating substances. My Pleasant Purgative 
Pellets will most admirably fulfill this indication and also favora- 
bly influence the secretory functions of the liver. If these are 
not at hand, a tea made of two parts senna, one of sage, and 
three of ginger, may accomplish the purpose. Foment the abdo- 
men 649), and relieve the pain in the bowels by taking my 
Extract of Smart-Weed. The next step in the treatment is to 
regulate the diet, and support the patient by mild, and easily- 
digested food. If the appetite be voracious, restrict the amount 
of food, and administer warm water-gruel, milk-porridge, and 
mutton-broth. In the chronic form of the complaint, the altera- 
tive action of my Golden Medical Discovery often proves to be 
the specific needed, when the diet is properly regulated and of a 
nutritious character. Likewise the application of compresses 
wet in alcohol will be found to be of essential service. The use 
of toning and supporting remedies is indicated, and all drastic 
or depleting treatment is strictly contra-indicated. A syrup 
made from rhubarb, blackberry briar, and golden seal, equal 
parts, is excellent to tone and astringe the bowels. 
1076. The peritoneum, or serous sack which lines the abdom- 
inal cavity and invests the intestines, is liable to become inflamed. 
When this occurs, the affection is termed peritonitis which may 
be divided into the acute and chronic forms. 
PERITONITIS. 
1077. Acute Peritonitis. This form may be partial; that is, 548 
COMMON SENSE MEDICAL ADVISER. 
confined to one spot, or it may extend over the entire surface 
of the peritoneum, when it is known as general. 
1078. Symptoms. There is headache, quick pulse, 
tongue coated with white, countenance pallid, features sharp, 
respiration difficult, nausea and vomiting, severe pain in the 
abdomen, which is extremely sensitive to pressure and becomes 
very much distended. There is also pain in the limbs, the bowels 
are constipated and in exceptional cases diarrhoea is a prominent 
symptom. The urine is deficient and there is sleeplessness, chil- 
liness and general prostration. Vomiting and spasms of coughing 
or sneezing produce pain. An erect position occasions intense 
suffering. The patient is compelled to assume a recumbent 
posture and is inclined to lie on his back, for in that position he 
experiences the least pressure of the vital organs against the 
peritoneum. He has an inclination also to draw up his limbs 
and retain them in a flexed position. 
1079. Causes. Prominent among these are injuries which 
have been inflicted upon the intestines, compression of the colon, 
or rectum, perforation of the stomach and bowels, either by vio- 
lence or some pre-existing disease, thus allowing the discharge of 
blood, urine, bile, or faeces into the abdominal cavity; also abor- 
tion, overdoing, exposure to w'et, cold, etc. As acute peritonitis 
is always a grave disease, involving more or less of danger to life, 
it is the wisest course to employ a physician and trust the case 
to his management. The same remark is equally applicable to 
the chronic form of the disease. 
1080. Chronic Peritonitis. Like tile acute, it may 
be either 'partial or general. This form is sometimes, though 
rarely, the sequence of the acute. When it appears independent 
of the acute, it is generally associated with some cancerous affec- 
tion pertaining to the abdominal cavity, and the inflammation is 
induced by the tumor. If chronic peritonitis be connected with 
the tubercular diathesis, tubercles will be discovered upon the 
surface of the stomach and alimentary canal, and they will also 
be found in the lungs, brain, etc. 
1081. When the affection is not tubercular, there will appear 
in the abdominal cavity an effusion of serous fluid of greater or 
less quantity, mingled with blood and pus. If such a discharge 
takes place, the abdomen gradually increases in size, or becomes ACUTE DIARRHCEA. 
549 
smaller than is natural. There is pain, attended by soreness 
upon pressure, and the patient becomes emaciated. 
1082. Inflammation of the peritoneum is frequently an ac- 
companiment to puerperal fever, which is a disease peculiar to 
childbirth, and arises from cold, or is communicated from one 
parturient patient to another by midwives. 
1083. Treatment. In the remedial management of acute 
peritonitis, it is obviously necessary to use some agent that can 
at once influence and change the congested state, and the inflam- 
matory condition of this serous membrane. Whatever will exert 
a specific effect upon this tissue, to modify and control the morbid 
initial changes, will also favorably affect the general condition 
of the system. One of the best agents employed to make a 
decided impression upon the extremities of the vascular system, 
subdue inflammation and modify its action, is the fluid extract of 
the veratrum viride (‘f 597), administered in full doses, continued 
and repeated until the system shows very decidedly its effects. 
Oftentimes it will abort the inflammation within twelve hours, 
and the patient will rapidly convalesce. Warm fomentations 
(*[ 649) applied to the abdomen are sometimes very serviceable, 
and are objectionable only because of their liability to dampen 
the bedclothes. When the abdomen will bear a thick, warm poul- 
tice, apply it, and then cover the entire surface with oiled silk. 
ACUTE DIARRHCEA. (“Summer Complaint.”) 
1084. A looseness of the bowels, attended with griping pains 
and sometimes with fever and thirst, is termed diarrhoea. The 
word means a “ flowing through.” Basing their distinctions upon 
the character of the discharges, medical men recognize three 
varieties of diarrhoea, viz: bilious, mucous and serous. 
1085. ISilions Diarrhoea is most common, and is 
recognized by the presence of bile in the evacuations. This 
gives them a yellowish or green appearance, and affords a ready 
clue to the cause of the derangement. The secretions from the 
liver are vitiated, or are excessive in quantity, and in either case 
they irritate the bowels, and cause effusions from their internal 
surfaces. The result is, frequent and thin discharges, in which 
the bile, which has caused the trouble, is carried off with the 
debris of its own destructive action. 550 
COMMON SENSE MEDICAL ADVISER. 
1086. Ill Mucous Diarrhoea the discharges consist 
of imperfectly digested food, mingled with a semi-transparent, 
slimy substance, of a ropy, tenacious nature. As the disease 
progresses this characteristic discharge becomes predominant 
among the excreted matter. 
1087. Serous Diarrhoea may be distinguished from 
either of the foregoing by the extremely thin and watery 
quality of the passages. 
1088. Symptoms. These may be very much the same 
for all the different varieties. There are usually abundant evi- 
dences that the digestion is impaired. In the bilious type, 
nausea and vomiting is not unfrequently a preliminary symptom. 
There is a gurgling or rumbling in the intestines, with wandering, 
griping pains. After a passage the patient is easier—may be 
quite free from distress for a short time—when the pains again 
return with unabated severity, and are followed by another 
discharge. The pulse is usually feeble, the surface cool and 
during the paroxysms of suffering a “cold sweat” may start 
from the pores of the forehead. 
1089. Causes. These are numerous. I have already- 
spoken of the manifest origin of "bilious diarrhoea. All the 
causes, however, may he grouped under two general heads, viz: 
(1), those which act directly on the mucous glands of the intes- 
tinal membranes, and (2), those which influence them indirectly, 
through the medium of the whole system. As examples of the 
first class I may mention unripe fruits, new cider, all indigestible 
articles of diet, worms, a sudden change from soft water to hard 
and vice versa, redundancy of acid in the stomach and depraved 
secretions. Cold affects the whole system and indirectly influ- 
ences the intestinal canal. It determines the blood to the 
internal organs, causing an increased secretion of bile and intes- 
tinal fluids, so that the mucous membrane becomes irritated. 
Diarrhoea is sometimes caused by an epidemic condition of the 
atmosphere. Arising from this cause, it always tends to assume 
a dysenteric form. A diarrhoeal discharge is a frequent accompa- 
niment of febrile diseases, and often occurs as a critical evacua- 
tion. When the abdomen is tender, the tongue inflamed at the 
edges, and the discharges watery, reddish or muddy, it is an un- 
favorable symptom and indicates a fatal termination. ACUTE DIARRHCEA. 
1090. Treatment. The general indications of hygienic 
management are (1) removal of intestinal irritation, and (2) pre- 
venting the determination of an undue amount of blood to the in- 
ternal organs. If the diarrhoea is caused by the impurity of the 
drinking water, pure milk may be substituted or else filter the 
water. If it is caused by indigestion, then the diet should be 
more liquid and nourishing, and mutton-broth, chicken-broth, 
oyster soup or beef tea, may be available. If there is irritability 
of the stomach and vomiting, administer a drink made of scorched 
corn meal, or what is better, a tea made from the green leaves or 
bark of the peach tree 599). A mild alkaline drink is also 
very excellent. Bathe the feet in water as hot as can be borne, 
and give my Extract of Smart-Weed freely. If it occurs from 
overloading the stomach, a cathartic is indicated, and my Pleas- 
ant Purgative Pellets will be found sufficient. Or a tea made of 
sage, senna and ginger may relieve the bowels. An extract of 
syrup of blackberry briar root 516), or of cranesbill 519), 
or an infusion of them, may be given alternately with my Com- 
pound Extract of Smart-Weed, when the latter used alone does 
not prove sufficiently restraining. Compresses wet in brandy, 
or what is better, the Compound Extract of Smart -WTeed, ap- 
plied to the bowels, are useful in cases of great local debility. 
If the stools are fetid, give fresh charcoal and milk; or mix equal 
parts of brewers’ yeast and water, and give freely of the water 
when the yeast settles; or make a mixture of one part carbolic 
acid 503), six of glycerine and sixty of water, and give an 
adult from half to a teaspoonful every houi\ When the bowels 
are irritable, a solution of superfine slippery-elm bark makes a 
very bland, mucilaginous drink. If the disease is disposed to 
resist domestic remedies, promptly summon a physician. 
1091. In weakness of the stomach and alimentary organs of 
infants, attended with diarrhoea, drop one or two live charcoals 
into water, just enough to make it alkaline, and charge it. with 
carbonic acid; heat the water and make a starch with flour, add- 
ing milk and a little sugar. Dried or scorched flour makes it 
more constipating. Of this compound the child may be fed 
freely. At other times I have used one part cream to two of 
warm, water, and one grain of hyperphosphate or sulphite of soda 
(«| 474)? to a meal. It can be varied by using one part of cream, COMMON SENSE MEDICAL ADVISER. 
one part of milk and one of water. The skin must be kept clean 
and the bowels stimulated by rubbing them often with my Com- 
pound Extract of Smart-Weed. The .infant must have good 
ventilation and may be carried in the open air, being always 
handled gently and not jolted about, thus giving it the benefit of 
the sunlight, but it should be kept perfectly warm. 
CHRONIC DIARRHOEA. 
1092. This obstinate disease is not unfrequently the sequel of 
the acute form of the same affection. The urgent and severe 
symptoms of acute diarrhoea are often abated, but the disease is 
not completely cured. The bowels are left in an irritable condi- 
tion—perhaps in a state of chronic ulceration, which perpetuates 
the irregular and morbid discharges. 
1093. {Symptoms. Most noticeable among these is the 
tendency to frequent and unhealthy discharges from the intes- 
tines. The evacuated matter will vary much in appearance and 
character in different cases. The precise location of the morbid 
conditions which give rise to the discharges, as well as their 
extent, will modify the color, consistency, and ingredients of the 
stools. Most frequently they are dark colored and of very offen- 
sive odor. They are of a more liquid character than is natural, 
except when, as is sometimes the case, periods of constipation 
alternate with the periods of unnatural looseness. Tormina 
(griping) is usually present, but not so severe as in the acute 
affection. Tenesmus (straining) often accompanies it. The ap- 
petite is impaired, there is debility throughout the system, and 
the patient is nervous and irritable. The complexion becomes 
sallow, the skin dry and rough, the tongue dark colored, and the 
patient grows weak and emaciated. 
1094. Causes. It may be the sequel to neglected or mal- 
treated acute diarrhoea, may arise from the injudicious use of 
powerful purgative medicines, may result from dissipation, un- 
wholesome food, bad air, absence of light, long continued 
exposure to dampness or cold, overwoi-k, extreme mental pertur- 
bation, and perhaps other causes. Sometimes it is attendant on 
other diseases, as Bright’s disease of the kidneys, scurvy, or some 
of the various forms of scrofula. 
1095. Diag nosis. This is more difficult than most readers CHRONIC DIARRIHEA. 
553 
may suppose. True, the more prominent symptoms are so ap- 
parent and so characteristic that the most unskilled may be able 
to decide that the patient has chronic diarrhoea. But to deter- 
mine in what portion of the intestinal canal the disorder is 
chiefly seated, to decide upon the extent of its ravages, to 
ascertain what peculiar shade or type the affection has taken on, 
to investigate its complications and modifications, to ferret out 
its producing or aggravating causes, and, above all, to nicely and 
skillfully adjust remedies to meet the depraved conditions, is by 
no means an easy task, even for the well-read and experienced 
physician. It should be borne in mind that this is a dangerous 
malady, and one that should not be trifled with or neglected. 
Its tendency is to corrode, abrade, and destroy the bowels—a 
process which, unchecked, must sooner or later result in death. 
There is little tendency to spontaneous recovery, nor will a 
removal of the exciting cause often be followed by recovery. 
The disease becomes so firmly seated, and the powers of life so 
debilitated, that nature cannot rally from the shock. 
1096. Treatment. All the suggestions heretofore made 
with reference to the treatment of acute diarrhoea, are equally 
applicable to the simple chronic variety. But as chronic diar- 
rhoea is more obstinate than the acute, and more frequently 
complicated with grave pathological conditions that must be 
distinguished, and properly met by specific treatment, it requires 
for its successful diagnosis and management, all the skill possessed 
by the most experienced specialist. 
CASES TREATED. 
1097. Ca§e I. In July, 1869, a gentleman from the country, 
aged 35, came to the World’s Dispensary for consultation and 
treatment. He had been suffering from chronic diarrhoea for 
over five years, and was reduced almost to a skeleton. The dis- 
ease was contracted while in the army. It commenced in that 
form known among soldiers as camp diarrhoea. He had dyspep- 
sia, torpid liver, frequent passages from the bowels,which varied 
in color and were very offensive. There was intestinal irritability 
and soreness, griping pain, restlessness, thirst, morbid appetite, 
heavily coated tongue, offensive breath, sallow complexion, cold 
feet and hands, with frequent attacks of headache. There was 554 
COMMON SENSE MEDICAL ADVISEE. 
also great irritability of the bladder, frequent desire to urinate, 
(yet passed but little urine,) pain in the back and loss of sexual 
power. Before this attack of diarrhoea he had good health; but 
as the disease wore on him, all those other ailments set in, and the 
man had become a complete wreck. This being a bad case and 
of long duration, a critical examination was made, when he was 
told that it would at best take a long course of treatment to 
effect his cure; that he would have to strictly comply with very 
rigid rules governing his diet, pay strict regard to all hygienic 
instructions given in order to have any prospect of recovery, and 
even with all this I could not positively assure him that he would 
regain his health. He decided to take treatment which was very 
carefully adapted to his weakened system, and modified from time 
to time to suit his condition and the symptoms as they arose. He 
continued under treatment but six months when he was discharged 
perfectly cured, and able to engage in manual labor, which he 
procured, and he has ever since been diligently following his vo- 
cation in this city. This case is mentioned to encourage those 
similarly afflicted. No one suffering from chronic diarrhoea 
should be given up as incurable. When the treatment is care- 
fully adjusted to suit the case, such old lingering complaints 
gradually yield, and health becomes firmly established. 
1098. Case II. In September, 1873, I received a letter 
from a gentleman residing in Pennsylvania, who desired my ad- 
vice in his case. He described it as follows: “I have had a 
diarrhoea for over six months, and none of onr physicians can 
effect a cure. I have from five to six passages every day, unless 
I take opium; and when I take this drug there will be more 
bloating of the bowels, and the diarrhoea is made worse. The 
passages are of all colors and very offensive. I have a good — 
yes, I may say ravenous appetite. Sometimes the food digests 
and sometimes it passes through me whole. I have pain in the 
small of my back, and an irritable bladder; I do not pass enough 
urine, and what I do void is high colored. My bowels feel sore 
all the time, and I can’t lift anything heavy without pain and an 
increase of the passages. My skin is dry and my hands and feet 
are cold most of the time. Now, doctor, what can you do for 
me ? ” I promptly replied that he could be greatly benefited and 
perhaps cured. In a few days I received a request from him to CHRONIC DIARRHOEA. 
555 
send medicines and advice. He was sent medicines to last him 
one month, and at the end of that time he wrote me that he 
thought he was better, and desired to continue the treatment 
right along. The second month he was much better, and at the 
end of the third he was perfectly cured. 
1099. Case III. In December, 1873, I received a long 
letter from a gentleman residing in Illinois, describing an 
ailment he called “looseness of the bowels.” He said he had 
been afflicted with this trouble ever since he came from the 
army, and that he had not been able to do work, to amount 
to any thing, for several years. He had been examined and 
treated by quite a number of eminent physicians, but all had 
failed in effecting more than a slight relief. After examining 
his symptoms as written out by him, I did not feel justified 
in prescribing for him, nor in hazarding an opinion as to his 
curability, without farther insight into the nature and cause of 
the frequent discharges. As he spoke of considerable bloat- 
ing of his feet and ankles, I suspected the diarrhoea might be 
caused by albuminuria or Bright’s disease of the kidneys. He 
was requested to forward a vial of urine, and upon analysis it 
was found to contain no albumen, but was heavily loaded with 
uric acid and very high colored. This became the key to a cor- 
rect diagnosis, attention being at once directed to his stomach, 
which failed to digest the food taken, giving rise to irritation of 
the bowels, emaciation, slight bloating of the feet and ankles, 
and all the conditions usually attendant upon a long continued 
drain upon the system. He was advised to regulate his diet 
carefully, and was given such bitter tonics and food solvents 
as a large experience in treating derangements of the digestive 
functions had proved most valuable, and he rapidly and fully 
recovered his health. 
1100. Other cases of chronic diarrhoea, too numerous to 
mention, have been treated quite as successfully as those here 
cited. Scarcely any two have been found to demand exactly 
the same treatment, so various have been the morbid conditions 
present, as recognized through the attendant symptoms. The 
larger number have been treated at a distance, without personal 
consultation, the patients making known their ailments by letter, 
and advice and medicines being sent them by mail and express. 556 
COMMON SENSE MEDICAL ADVISER. 
BLOOD Y-FLUX. (Dysentery.) 
1101. The term “dysentery” is used to designate an inflam- 
mation of the large intestine, attended with mucous and bloody 
evacuations. It is called sporadic when it is produced from acci- 
dental causes, epidemic when it generally prevails, and endemic 
when it occurs where persons are croAvded together, as in prisons 
or armies. During the Peninsular war, five thousand soldiers 
perished from this disease, and in the late rebellion thousands 
became the victims of its ravages. It is very prevalent in tropical 
and temperate climates, especially during the autumn months. 
It comes with varying grades of intensity in the acute form, and 
the chronic form is generally the sequel of the acute. 
1102. Symptoms. This disease is usually preceded by a 
derangement of the digestive organs, diarrhoea, chills and fever, 
and a depression of the bodily energies. The surface of the 
body is hot and dry, while the hands and feet remain cold. The 
evacuations are frequent, slimy, or jelly-like, mixed with bloody 
fcecal matter. There is frequent, if not constant desire to 
evacuate the bowels, and a disposition to strain, called tenesmus. 
The griping or colic pains that precede and provoke this desire 
to sit and strain, are called tormina. If the tormina and tenes- 
mus are prominent symptoms, the attack is correspondingly 
acute. The tongue may present a natural or frosted white 
appearance. There is also urgent thirst, and occasionally vomit- 
ing. The evacuations vary in color and form; sometimes round, 
bard lumps pass, which are termed scybala, at other times, shreds 
of mucus tinged with blood, or an acrid humor, like the washings 
of raw meat. These discharges are often preceded by cramps in 
the limbs and thighs, and succeeded by an intense burning sensa- 
tion in the rectum and anus, accompanied by an irresistible 
inclination to sit and strain, until sometimes, the intestine is 
forced beyond the anus. 
1103. Tlie Causes are various, as sudden changes of 
weather, irregular habits, improper diet, and cold, resulting in 
obstructed perspiration. 
1104. Treatment. The treatment may be commenced 
by thoroughly bathing the feet in warm water, or the adminis- 
tration of the spirit vapor-bath 630) to induce perspiration and COLIC. 
557 
equalize the circulation. Then foment the bowels with cloths 
wrung out of water as hot as can be borne. The patient should 
assume the recumbent posture, being well covered to prevent 
chilliness. If there is an uncontrollable desire to evacuate the 
bowels, use an injection of cold water or slippery-elm solution, 
and for an adult take a piece of soft opium as large as a small 
bean, and introduce it within the anus and allow it to remain. 
Also take internally a weak solution of alkali every twenty min- 
utes, or a tea of slippery-elm. Many times the medical treatment 
may advantageously be commenced by giving a cholagogue 
cathartic (*[ 533) to unload the bowels of irritating substances 
and arouse the biliary and other secretions, after which the dis- 
charges are readily controlled. My Pleasant Purgative Pellets 
will admirably fulfill this indication. Their operations may be 
followed by full doses of my Compound Extract of Smart-Weed 
to control the discharges. Gelsemin- 598) in doses of one- 
sixteenth to one-eighth grain, repeated every one or two hours, 
acts specifically in subduing the inflammation, arresting the 
bloody discharges and controlling the fever. It will act harmo- 
niously with the means already recommended and may be given 
alternately with the Extract of Smart-Weed. The gelsemin 
should be triturated with white sugar, by the apothecary, as direc- 
ted in 598. Should the disease not promptly yield to the treat- 
ment already advised, it may be considered very malignant in 
character, demanding the services of the family physician. 
COLIC. 
1105. Colic is characterized by griping pains in the abdomen, 
which are sometimes accompanied with nausea and vomiting. It 
is recognized in several forms, some of which I shall briefly 
describe. 
1106. ESISions Colic. This may be the result of a mor- 
bid condition of the liver. 
1107. Symptoms. There is severe pain which occurs in 
paroxysms, and momentary relief may be obtained by pressure 
upon the bowels. The pulse is quick, tongue coated, and skin 
harsh and dry; there is headache, impaired appetite, acrid taste 
in the mouth, thirst, nausea attended with vomiting and general 
chilliness followed by febrile symptoms. 558 
COMMON SENSE MEDICAL ADVISEE. 
1108. Causes. It may be induced by exposure to the 
cold, in consequence of which the circulation is impeded, the 
pores of the skin are obstructed and all of the vitiated matters 
have to be expelled through the liver, stomach and intestines. 
It may also be due to the malaria in the atmosphere, since it 
most commonly occurs during the autumn, after a season of hot 
weather. 
1109. Flatulent Colic. Flatulent or wind colic is one 
of the results of indigestion. 
1110. Symptoms. A sense of fullness in the pit of the 
stomach, attended with pain which is transferred from one part 
of the bowels to another. There is fever, quick pulse, nausea- 
and the presence of wind; by the latter feature it can readily be 
detected from the other forms. 
1111. Causes. Cold or variable atmosphere, partaking of 
unripe fruits, uncooked vegetables and those articles of diet 
which ferment instead of digesting. 
1112. Painters’ Colic. This form is also known by 
various names, as colica pictonurh, saturnine or lead-colic, all of 
which have reference to lead poisoning. Those persons who are 
engaged in the manufacture of lead, and also painters, are the 
most frequent victims of this affection. 
1113. Symptoms. Impaired appetite, fetid breath, 
thickly coated tongue, obstinate constipation, dry skin, scanty 
urine, languor, severe pain in the umbilical region, and general 
derangement of the functions of the system. 
1114. Causes. From the term applied to this form, the 
cause may be inferred. It is induced by the absorption of lead 
through the lungs, stomach and skin. 
1115. Treatment. The indication to be fulfilled in 
bilious colic is to relieve the intestinal spasm. This may be done 
by drinking freely of a decoction of yam-root (dioscorea villosa), 
512), which has proved to be a specific remedy in this affec- 
tion. If this is not at hand, the spasm may be relieved by using 
opium and assafetida 508); take two grains of each and make 
into two pills, and give them both at a dose, repeating every two 
hours, until the pain be allayed. If the stomach is irritable, a 
tablespoonful of laudanum and one of tincture of lobelia, (^f573), 
in an ordinary injection of catnip tea may be useful. If simple OBSTRUCTION OF THE INTESTINAL CANAL. 
559 
means do not promptly arrest the attack, no time should be lost 
in summoning the family physician. 
1116. In flatulent colic, the treatment must depend upon the 
cause. If it is occasioned by cold, a teaspoonful or two of my 
Extract of Smart-Weed, in wann water or catnip tea, repeated 
a few times, will be sufficient. If it results from overloading the 
stomach, a dose of my Pleasant Purgative Pellets will answer 
the purpose. If the pain in the abdomen be severe, apply hot 
fomentations 649). Assist the action of physic by giving an 
injection of senna and catnip tea, or if the stomach be very sour, 
take internally some mild alkali 473). 
1117. In painters' colic, the remedy used to be the “ White 
Liquid Physic,” made as follows: sulphate of magnesia (epsom 
salts), twelve ounces; nitrate of potassa (saltpetre), half an ounce; 
sulphuric acid, one drachm; boiling water, one quart. Of this 
remedy give a tablespoonful every thirty minutes or every hour, 
until the bowels move. An injection of warming teas or of alum 
water is a good remedy. Castor oil and molasses, containing a 
teaspoonful of spirits of turpentine, will add to the efficiency of 
an injection. If the colic be not promptly relieved, it is better 
to employ a physician. 
OBSTRUCTION OF THE INTESTINAL CANAL. 
1118. The intestinal canal is liable to be obstructed and the 
passage of its contents prevented. The jffiases of obstruction are 
variously termed invagination, impacted faeces, and compression 
or stricture. 
1119. Invagination or Intussusception of the 
intestines, signifies the introduction of one part of the intes- 
tine into another. It may occur at any point in the intestines, 
although it generally takes place near the termination of the 
ileum 52, Fig. 29). 
There are various theories with regard to the process of invag- 
ination; one is, that a certain portion or segment of an intestine 
becomes concentrated, while that adjoining it is dilated, and the 
one passes readily into the other. 
When an intestine passes into one below it, the condition is 
termed progressive invagination; when the process is reversed, 
it is termed retrograde invagination. It generally takes place 560 
COMMON SENSE MEDICAL ADVISEE. 
from above downward, and the invagination may occur so low 
that the intestine will protrude from the anus. 
1120. Symptoms. Persistent constipation, tenderness in 
the abdominal region, sudden attacks of pain, nausea and vomit- 
ing, are prevailing symptoms. In rare instances the matter 
vomited has the odor of the faeces, showing that the intestinal 
contents have been ejected by the mouth. This is however of 
unusual occurrence. The pulse is quick and the extremities are 
cold. Some who have diagnosed the disease, have discovered a 
hard tumor on the left side of the abdomen, and hence located it 
in that place. Post-mortem examinations have exhibited great 
inflammation of the mucous membrane of the intestines, as indi- 
cated by their dark red color, and not unfrequently the peritoneal 
sheath has the appearance of being inflamed. 
1121. Impacted Faeces are excrementitious substances 
which become lodged in the intestinal canal, thereby obstructing 
the passage and preventing free evacuations. These hardened 
masses may accumulate in any part of the colon or caecum, but 
in aged persons they oftenest form below the sigmoid flexure in 
the rectum (Fig. 29). It is remarkable to what extent the bowels 
may become impacted: cases ai'e recorded where months have 
elapsed without the subject having had an evacuation. In other 
instances it has been ascertained that when injections have been 
used to obtain a movement of the bowels, the contents below the 
obstruction only, have been removed, and without affording the 
desired relief. 
1122. Symptoms. There is more or less pain, the skin 
is harsh and dry, the tongue thickly coated, the stomach irritated, 
there is nausea accompanied by vomiting, symptoms of fever, 
and a feeling of general debility. If the accumulations be great, 
the abdomen will become distended, and sometimes these masses 
can be distinctly felt in the place where they are located. 
1123. Causes. Obstruction from impacted faeces generally 
commences by tbe introduction of some foreign substance within 
the intestinal canal, and its lodgment there. This substance 
is often a fish-bone, seeds or stones of fruit, mustard seed, or 
carbonate of iron improperly administered, all of which have 
been known to collect and become indurated upon the intestines; 
or it may be that a gall-stone has been lodged in the passage. OBSTRUCTION OP THE INTESTINAL CANAL. 
561 
With some one of these materials as a centre, earthy deposits, 
composed of the indigestible constituents of food, have been 
made about it, until the intestinal passage has become obstructed, 
and the faeces, thus denied a free exit from the system, have 
accumulated and hardened. Sedentary habits may also induce 
an accumulation of excrement within the intestinal walls. 
Impacted faeces may occasion tumors in the mucous coat of 
the intestines and prevent the passage of its contents; these 
symptoms should be clearly distinguished. They are located in 
the colon, and do not often occasion pain upon being pressed 
with the finger. The removal of a faecal tumor generally obvi- 
ates the difficulty, and regular evacuations of the bowels are 
again established. 
1124. Compression, or Stricture. Obstruction of 
the intestines may arise from tumors forming externally, or from 
abnormal growth within the intestinal canal, or from the scarring 
produced by the removal of ulcers. This is liable to take place 
in the rectum, in which case it can easily be ascertained by 
examination. It may be in the colon; if so, it will not be so 
readily determined, the physician’s skill being necessary to ascer- 
tain its location. Again, it may occur in the small intestine. 
If so, the colon will not be distended, and evacuation may take 
place from below the obstruction. Distention may induce rupture 
of the intestine. 
1125. Treatment. If the intestine is invaginated, it will 
be wrong to attempt to force a passage by the use of purgatives, 
for they will only increase the difficulty. The indication is to 
relax the spasm and thus gain a passage, and it is sometimes 
accomplished by injecting a large quantity of warm water into 
the bowels. The value of the injection may be enhanced by 
adding to it thirty drops of the fluid extract of hyoscyamus 
586) and a drachm of tincture of assafetida, 508). These 
cases are so important that they ought to be treated by a com- 
petent physician, for if the intussusception has become adherent, 
these remedies will be insufficient. 
1126. If the intestine be obstructed by impacted fences, the 
remedy is a free discharge from the bowels. A stimulating pur- 
gative injection of senna tea, castor oil and salt will generally 
remove the accumulations in the colon; then follow with a dose 562 
COMMON SENSE MEDICAL ADVISEE. 
of four or five of my Pleasant Purgative Pellets. The patient 
ought to partake of some boiled cracked wheat at each meal, as 
it is one of the best articles of diet to keep the contents of the 
bowels in a soluble condition. It may be cooked and served in 
the same manner as boiled rice. 
1127. In the treatment of stricture of the intestine, the diet 
should be nutritious and concentrated, in order that there be 
little faecal matter to pass the bowels. If the stricture be in the 
lower part of the bowels, it may be mechanically distended and 
overcome. Active purgatives are contra-indicated, but the use 
of injections is proper. Colic pains may be relieved by ano- 
dynes 479). All strictures of the intestines are very serious, 
and therefore I should advise the employment of a professional 
attendant. 
DISEASES OF THE LIVER. 
1128. Although for centuries past the liver has been the sub- 
ject of extensive research, yet there still exist differences of 
opinion with regard to the functions which it performs. It is 
the largest gland 54) in the human body. It is the great 
depurating (purifying) organ of the system, and has very ap- 
propriately been termed the “housekeeper” of health. Form- 
erly it was regarded as an excretory organ, but latterly it has 
been shown to be an important organ also of secretion, the func- 
tions of which are to change the composition of the blood, 
purify it—by abstracting certain elements—assist in the produc- 
tion of animal heat and favor digestion and nutrition. 
1129. The duties of this organ are remarkable in that they 
are anticipatory as well as successive. Its functions anticipate 
the requirement of bile to complete the digestive process. This 
substance undergoes wonderful transformation in the digestive 
fluids, loses its identity, re-enters the blood under a new form, 
assists in nutrition, and is then re-secreted, it having served in 
company with those carbonaceous elements, from which it is noAV 
separated. Thus it assists in various relations, conditions and 
combinations, and while some of its elements, as cholesterine, 
sulphur, etc., are eliminated as excrementitious, yet most remain 
in the system, after being separated from the blood, to perform 
various vital offices. DISEASES OF THE LIVER. 
563 
1130. After effecting these physiological changes, it would 
become a poisonous agent, were not its elements deftly abstracted 
from the blood by the analytic process termed secretion. Any 
derangement of the secretory function of the liver is liable to 
result in disease of other important organs, as the heart, lungs, 
kidneys, skin, stomach, or brain. 
1131. There are various opinions with regard to the probable 
amount of bile daily secreted. From experiments made upon 
carnivorous animals, Bidder and Schmidt have been led to the 
conclusion, that in a man weighing one hundred and forty 
pounds, about two and a half pounds of this fluid are secreted 
per day. If, in consequence of tight clothing or any mechanical 
impediment, congestion, functional torpor, chronic disease, slow 
inflammation, or hardening result, or if, from any cause, the 
liver be disabled in the performance of its duties, it is obvious 
that the elements of the bile must remain in the blood, irritating, 
poisoning, and perverting every vital process. 
In this juncture of affairs, what can the organism do ? It 
seems conscious that these elements, in other relations so indis- 
pensable to health and life, if not now extricated from the blood 
will poison it, and through it the entire system. Therefore the 
skin, lungs, bowels and kidneys, rally to this emergency, and in 
addition to their own regular duties, make desperate attempts to 
rid the system of these noxious materials. These contaminating 
elements, by being removed through the skin, disorder it with 
pimples, blotches, boils and carbuncles; or cause irritation of 
the lungs, as indicated by cough, asthma, bronchitis and con- 
sumption; or functional disorder of the bowels, as constipation, 
piles, diarrhoea and dysentery; or, perhaps, organic.disease of 
the kidneys and bladder. Often the brain manifests symp- 
tomatic disorders, as dullness, dizziness, headache, impaired 
memory, gloom and hypochondria. The process of nutrition is 
perverted, the functions of the blood-vessels disordered, the 
circulation materially disturbed, and all the functions of the body 
are morbidly influenced. 
1132. These in turn react upon the liver, so that the functions 
of this organ become still more deeply involved; the portal ves- 
sels (1" 54, 67, 98) are congested, inflammation and induration 
follow, succeeded by other organic diseases. Hardening of the 564 
COMMON SENSE MEDICAL ADVISEE. 
liver may be the cause of abdominal dropsy, affections of the 
heart, derangement of the digestive organs, Bright’s disease of 
the kidneys, and even pulmonary consumption. 
1133. Causes. Among the causes of “ liver complaint ” 
we may mention overexertion, unduly heating the body, expo- 
sure to currents of air, vicissitudes of climate, as extremes of 
heat and cold, sudden variations of temperature, insufficient 
clothing, continued compression of the vital organs, irregular 
habits, loss of sleep, drinking cold water when the body is heated, 
too stimulating diet, excessive use of spirituous liquors, sedentary 
habits, constipation of the bowels, improper medical treatment, 
the use of harsh, heroic medicines, mercurials, excessive use of 
purgatives, blows, injuries or contusions in the region of the 
liver, irritation from biliary concretions, violent rage or deep 
sorrow, solar heat and malaria. These are prominent agents in 
producing this disease. Solar heat excites the skin, and malaria 
the liver, to excessive action. The cold night air checks the 
functions of the former, on account of which fever follows, suc- 
ceeded by inflammation of the liver. The sudden changes of the 
New England climate, the malarial influences of the West and 
the heat of the South, together with the perverted dietetic habits 
of our people, tend to develop diseases of the liver throughout 
the United States. 
1134. I have observed in the dissecting room, and also in 
making post-mortem examinations of the bodies of those who 
have died of various diseases, that in a large proportion of cases 
the liver has given evidence of having at some time been diseased. 
This affection is equally prevalent in beasts; every butcher knows 
that the livers of cattle, sheep and swine are ten times as fre- 
quently diseased as any other organ. 
1135. Acute Inflammation of* the Uver. 
[Acute Hepatitis.) This disease is of rare occurrence in the 
temperate zones. The inflammation, being seated in the sub- 
stance of this organ, terminates either by a gradual return to 
health [resolution), by the formation of matter [suppuration), 
or by chronic inflammation, attended sometimes with enlarge- 
ment [hypertrophy). 
1136. Symptoms. Chilliness, nausea and vomiting of 
bilious matters, a sense of oppression and constriction in the DISEASES OE THE LIVER. 
565 
region of the stomach and liver and intense heat of the skin; 
the tongue is coated yellowish white, the pulse is hard, full and 
strong, there is severe pain across the temples and forehead 
attended with dullness and languor, the eye, skin and urine are 
tinged with yellow, there is difficulty of respiration, dry cough, 
pain in the right shoulder, collar-bone and in the region of the 
liver, which may be dull and obtuse, or sharp and lancinating. 
There is more or less tenderness on pressure over the liver, the 
patient is inclined to lie on the right side, the appetite is im- 
paired, the thirst great, the bowels are constipated or the opposite 
condition prevails. The symptoms vary according to the 
severity of the attack, and the extent of the inflammation, and 
if the disease does not end in resolution, it generally terminates 
in suppuration. If the abscess points outwardly, it may be 
opened by incision and the matter liberated. The pus is some- 
times discharged into the bowels and evacuated, or into the 
lungs and expectorated. Recoveries are rare in the latter case 
and the disease is always fatal when the matter is discharged 
into the abdominal cavity and can find no exit. 
1137. Treatment. The general directions under the 
head of inflammation 720) will apply to the management of 
this inflammation. If there be nausea and vomiting, a thorough 
emetic (T 570) should at once be given. If there be fever, hot 
skin, quick pulse and thirst, give veratrum and aconite 
(*[[ 596) with pleurisy-root tea 550), repeating the doses every 
hour. To promote sweating, give my Compound Extract of 
Smart-Weed. Hot fomentations 649) may be applied over 
the right side to relieve congestion. When the pulse is softened 
and sweating is induced, give a cathartic, 533), as a dose of 
four or five of my Pleasant Purgative Pellets. For nausea and 
irritability of the stomach, make a drink by dropping a few live 
hardwood coals into a tumbler full of cold water; these will also 
charge it with carbonic acid, which in these diseases proves very 
acceptable to the stomach. When convalescence is established, 
give of my Golden Medical Discovery 620) a teaspoonful 
dose from three to six times a day, to prevent the disease from 
assuming a chronic form. If the inflammation does not readily 
yield to this treatment, a physician should be called, as dangerous 
complications are liable to arise. 566 
COMMON SENSE MEDICAL ADVISER. 
CHRONIC INFLAMMATION OF THE LIVER. 
(Chronic Hepatitis.) 
1138. This is what is ordinarily called Liver Complaint, Torpid 
Liver, Bilious Disorder, Disease of the Liver, etc. 
Under this head may he considered all those chronic affec- 
tions, known as congestion, induration and enlargement of the 
liver and which result in deficient action, functional derange- 
ment, morbid secretion of bile, and various disorders of long 
standing. 
1139. Symptoms. Owing to the liability of other or- 
gans becoming diseased during the progress of chronic affections 
of the liver, great precision and accuracy of judgment are re- 
quired to determine by the symptoms, the organ which is 
‘primarily diseased and those merely symptomatically involved. 
This presupposes, not only familiarity with the signs of a com- 
plicated ailment, but also an exact anatomical knowledge of the 
diseased organ, of the morbid changes which occur in its struc- 
ture, and their results to its own functions as well as those of 
other organs. 
1140. The symptoms may differ according to the circum- 
stances, aptitude, temperament, sex, age, or constitution of the 
individual, and the complications of the disease. The local indi- 
cations are fullness of the right side, thus denoting congestion 
of the liver; a dull, heavy pain, which is increased by pressure 
or by lying on the left side; a sense of fullness, weight, and 
oppression, about the stomach; an aching in the right shoulder- 
blade; a dull, disagi-eeable pain in the shoulder-joint, which may 
extend down the arm, and is sometimes felt in the wrist and 
knuckle-joints of the hand. Not unfrequently the complexion 
becomes pale and sallow, and there is puffiness under the eye, 
headache, a bitter taste in the mouth, tongue coated white or 
covered with a brown fur, and the gums are very hard; there is fre- 
quent sighing, hacking cough, fever, restlessness and loss of sleep; 
sometimes an unnatural, greasy appearance of the skin, at others, 
it is dry and harsh, has scaly or branny eruptions, pimples, dark 
blotches, and troublesome itching. The urine is frequently scanty 
and high-colored, but variable as to quantity and appearance; it 
often produces a scalding sensation when voided, and if allowed CHRONIC INFLAMMATION OF THE LIVER. 
567 
to stand, deposits a sediment which sometimes contains albumen. 
The pulse is slow, very slow, particularly when the elements of 
the bile are not eliminated from the blood. The pulsations of 
the heart are easily quickened, and palpitation is excited if the 
blood be low and anaemic. There is depression of spirits and a 
decided tendency to be discouraged and despondent. The func- 
tional powers of the stomach are impaired, there is loss of appe- 
tite, or it becomes capricious, uneasiness is felt in the region of 
the stomach, oppression, sometimes nausea and water-brash, or 
there is indigestion, flatulency, and acid eructations, the bowels 
become irregular, usually constipated, and occasionally subject 
to obstinate diarrhoea attended with colicky pains, the stools are 
light clay-colored, sometimes hard and dark, again thin and very 
offensive, and now and then green or black. As the disease pro- 
gresses, during the day the circulation is sluggish, the feet and 
hands are cold, but at night the pulse is accelerated, and the 
palms of the hands and soles of the feet have a burning sensation. 
1141. The foregoing symptoms are not all present in one 
case, nor are any two cases alike in every respect. They vary 
according to the organs most implicated in the hepatic derange- 
ment. Thus, when chronic inflammation of the liver is associated 
with heart disease, the patient may have palpitation, excessive or 
defective action of the heart, attended wTith more or less pain 
and shortness of breath. If the lungs be specially influenced, 
then, in addition to the ordinary hepatic symptoms, there may 
be a dry cough, asthma, hurried respiration, bronchitis, hoarse- 
ness, pain in the chest, etc. If the stomach be the sympathizing 
organ, the tongue will be coated white or brown, there will be 
nausea, loss of appetite, flatulency, acidity, dyspepsia, fullness 
and oppression, amounting sometimes to pain in the stomach 
after taking food, which ferments and gives rise to eructations 
and various other disordered manifestations. If the bowels be 
morbidly influenced by this affection, there is constipation or 
diarrhoea, griping pain, distention of the abdomen, piles, and pain 
just within the points of the hips, thus indicating irritation of 
the colon. If the brain or nervous system sensitively responds, 
it gives rise to headache, dizziness, disturbed sleep, nightmare, 
depression of spirits, peevishness, capriciousness, lack of ambition, 
irritability, and congestive symptoms. When the skin indicates 568 
COMMON SENSE MEDICAL ADVISER. 
its influence, the surface is dry, harsh, and scaly, displaying dark 
“moth-spots,” blotches, or numerous little sores, and the coun- 
tenance has a dull, tawny look. If the kidneys be disturbed by 
it, there may be pain and a sensation of weight in the back, 
wdiile the urine is scanty and high-colored, or abundant, pale, and 
limpid, frequently charged with sedimentary products of disease, 
and voided with difficulty. If the womb be implicated in this 
chronic affection, the menstrual function may be deranged, and 
result in an excessive monthly flow, or be scanty, and followed 
by profuse leucorrhcea. 
1142. The preceding allusions to the complications of chronic 
inflammation of the liver, show the necessity of clearly distin- 
guishing between the symptoms of this disorder and those reflec- 
ted by the organs which sympathetically respond. To make our 
discriminations more effectual, and put the diagnosis beyond 
doubt,we make a chemical examination of the urine, and thereby 
detect the morbid products which it contains and direct attention 
to the diseased organs furnishing them. Likewise we examine 
the urine with one of the latest improved microscopical instru- 
ments, and by it discover, with astonishing accuracy, the mor- 
bid changes and distinguishing products which constitute the 
farther evidence of each particular disease. These examinations, 
in connection with a complete history of each case, a classification 
of the symptoms, and a knowledge of the individual tempera- 
ment and diathesis (which can be ascertained by a photograph of 
the patient), enable us with facility, exactness and nice precision 
to detect, analyze and perfectly understand disease. 
1143. Before entering upon the consideration of treatment, 
let us casually glance at the functions of the liver. First, by an 
act of transformation, it removes matters which, if allowed to 
remain in the blood, would become noxious and unfit it for the 
farther support of the body. Second, by secreting bile, it fur- 
nishes to the digestive organs a fluid which assists in converting 
the food into chyle, combines eholesterine with the residual mat- 
ter, stimulates the intestine to action, and then this fluid is itself 
transformed and absorbed with the chylous products, after which 
it circulates with the blood and assists in nutrition until, becom- 
ing injurious and pernicious, it is resecreted and re-elaborated to 
serve again, as described. CHRONIC INFLAMMATION OF TIIE LIVER. 
569 
1144. For its growth and nourishment, the liver is furnished 
with blood by the hepatic artery; but for the purpose of secre- 
tion and depuration, it is abundantly supplied with venous blood 
by the portal system—a union of all the veins—which carries it 
to that organ from the spleen, stomach, pancreas and intestines. 
This impure, venous blood, now surcharged with biliary elements, 
which must be withdrawn from it, is freely poured into the 
minute network of this glandular organ. In a healthy condition 
of the liver, the carbonaceous elements of the blood are turned 
into sugar, and the constituents of the bile are liberated by the 
liver, and set apart for further duties. When it fails to elimi- 
nate these noxious elements from the blood, it is itself thoroughly 
vitiated by them. 
1145. When this organ is congested, embarrassed and pois- 
oned, how ought it to be treated ? Shall we administer harsh, 
irritating and life-endangering remedies, exterminating disease 
after the manner of destroying rats ? Or shall we treat the liver 
kindly, and encourage and sustain its faltering functions ? The 
manner heretofore has been to regard it as a vicious delinquent, 
worthy of many punishments by drastic purgatives, poisonous 
mercurials, arsenic, blisters and blood-letting. We are glad for 
the sake of suffering humanity, that these heroic penalties, sup- 
posed by many medical men to be corrective remedies, are 
becoming obsolete, and belong chiefly to medical history. As 
people become enlightened they are more humane and sympa- 
thetic, and instead of goading an overtaxed organ to perform 
impossible tasks, they now try to relieve it of congestion and em- 
barrassment, and encourage the skin, bowels and kidneys in their 
mutual efforts to render assistance to the liver in its emergency. 
In this manner nature indicates a congenial, restorative plan of 
remedial treatment. Let us proceed to consider these indications. 
1146. What I know about the Mal-treat- 
Blient ©f* the litver. I may allude to the hurtful and 
injurious methods of treating this organ without reflecting upon 
the motives of any class of practitioners. 
In years past, but within the memory of some of our oldest 
inhabitants, the qualifications of a first-class school master con- 
sisted in muscle, alertness and physical ability. It inspired more 
confidence and respect among a certain class of boys than any 570 
COMMON SENSE MEDICAL ADVISER. 
number of scholarly acquirements. Nowadays thought gov- 
erns. But many physicians have not kept pace with the 
improvements and continue to administer great, repulsive, sick- 
ening doses of medicine. For example, huge, drastic pills, 
calomel, blue mass, mandrake, podophyllin are given with a view 
of coercing the liver to action. Milder remedies scarcely excite 
their respect. The impression seems to prevail with them that 
disease has set up a rebellion within the territory of the liver, 
and that a military force of remedies is required to subdue it. 
Such is the heroic course of treatment, based upon a misunder- 
standing of both the nature of the disease and the action of 
remedies upon the system. The liver is the scene of fearful col- 
lisions and remedial combats. The medicinal soldiery employed 
ofttimes pillage and lay waste, beyond hope of recuperation, the 
resources of the blood and life. The polished lancet now lies 
rusting in its sheath. Calomel and other mercurial Samsons, 
are now and then exhibited, but, in the main, their “ occupation’s 
gone.” These agents were once favorites with the people and 
many medical men of a strongly conservartive temperament are 
loth to give them up, even now that they can be so easily replaced 
by far more congenial remedies. But knowledge is being dif- 
fused, education is lifting the masses, and dear-bought experience 
is opening the eyes of thousands, who now believe in hygiene 
and remedial restoration, rather than in the employment of 
debilitating, exhausting and disease-creating medicines. 
1147. Treatment. Food must be rich in carbon ill order 
that it may build up the tissues and keep the body warm, but 
the result of the combustion — carbonic acid — must be removed 
from the blood, or death will ensue 73). So bile is necessary 
to digestion, nutrition and life; yet, if it be not separated from 
the blood by the secreting action of the liver, it will as surely 
poison the system and destroy life as carbonic acid. Although 
the constituents of the bile pre-exist in the blood, they must be 
removed in order that the blood may be rendered more fit to sup- 
port the body, while the secreted bile is destined to assist in 
digestion, and the mysterious processes of nutrition. Therefore, 
we may combine two indications in one, —(a) induce a secretion 
of bile, (b) restore the normal activity of the liver. This should be 
done, not by administering stimulants, but by, so far as possible CHRONIC INFLAMMATION OF THE LIVER. 
571 
relieving it of all contingent embarrassments. Would any one 
think of giving to a weak, debilitated man large portions 
of brandy to enable him to work ? Does not every one know, 
that when the unnatural stimulus is removed, he fails ? Apply 
this principle in the treatment of the liver. When harsh, unnat- 
ural stimulants and “ bile-driving ” medicines are administered 
for a time and then withheld, the liver relapses into a more tor- 
pid and debilitated condition than before treatment was begun. 
Is not this true of nine-tenths of all who suffer from this malady, 
and have recourse to this class of remedies ? 
1148. Then how may we remedially fulfill the preceding in- 
dications ? I answer in the language of a distinguished author 
and standard medical writer, “ by using a class of agents which 
should never be overlooked in the treatment of long-standing 
liver diseases, chiefly addressed to the blood and denominated 
‘Alteratives.’ ” And why employ this class ? Again I reply 
that the best alteratives are called Catalytics, because they act 
to counteract a morbid material or process, and then pass out of 
the system, without leaving an unfriendly trace or unfavorable 
token. I use a compound prepared from tonics and restoratives 
combined with catalytic remedies. This corrective mixture sus- 
tains the action of the liver, and restores the blood by supplying 
it with a material which is required, but which has been exhausted 
by disease. This remedy is intended to neutralize the virus 
of malaria in the blood, specifically counteract the influence of 
the constituents of the bile, and prepa*e them for elimination by 
the bowels, skin or kidneys. Catalytic alteratives frustrate the 
noxious action of biliary matters in the blood, thwart and defeat 
many of their ill consequences, and give more time and opportu- 
nity for the liver to resume its natural functions. 
1149. Tonics, restoratives, and alterative catalytics, are re- 
quired not only in diseases of the liver, but in a large number of 
ailments where the blood becomes charged with morbid materials. 
The active remedial properties of the most efficient agents of the 
above classes of medicine now known, are scientifically combined 
in my Golden Medical Discovery, which acts especially upon the 
blood, and hence influences the system generally. It is also 
powerful in eliminating those morbid humors which are after- 
wards subjected to excretion through various organs. 572 
COMMON SENSE MEDICAL ADVISEE. 
1150. Its action is radically different from most medicines 
employed in chronic diseases, for the reason, that what is usually 
prescribed is something corrosive, harsh, and powerful, expected 
to “ knock down ” an inflammation, and violently and suddenly 
“ drag out ” the morbid humors of the system ! Unless the 
disease be temporary, it may return with increased violence, and 
the patient be again bowed down by its strong hand. The treat- 
ment is more vigorously renewed, but the disease is still more 
resisting, while the failing bodily powers foretell a fatal termina- 
tion, and the shadow of death already looms up in the distance. 
Common observation verifies these remarks, and the truth of 
them is constantly illustrated by the sad experience of thousands 
of sufferers. 
1151. I have been very minute in the description of the 
remedial properties of the Golden Medical Discovery, and have 
relied upon the reason and intelligence of my patrons, believing 
that they can in a degree understand why I deem it so applicable 
to the system in its remedial operations. It does not debilitate 
the liver by overstimulation, nor irritate the stomach and bowels 
by disturbing the delicate processes of digestion, neither does it 
act with severity upon the blood, but it operates so gently, insen- 
sibly, and yet with so much certainty, that it excites the surprise 
and admiration of the patient. 
1152. From the careful detail of its various properties, there 
is abundant reason for its favorable action upon all of the emunc- 
tory organs and processes, which co-operate in the removal of 
morbid materials from the system. If, however, the bowels are 
unusually sluggish (chronically constipated), it would be advisa- 
ble, in conjunction with my Golden Medical Discovery, to use 
my Pleasant Purgative Pellets, which are powerfully alterative, 
besides being mild, gentle and unirritating, in their operation. 
They are the natural allies—remedial assistants—to the Discovery, 
and the two work harmoniously together. They should be taken 
in small doses, and their use perseveringly followed, until the 
bowels are properly regulated by the use of the Discovery. 
1153. I know it lias been customary to resort to powerful 
drastic cathartics, followed by bitters prepared in dilute alcohol. 
This habit is unphilosophical as well as unscientific, for who does 
not know that alcohol deranges the functions of the digestive CHRONIC INFLAMMATION OF THE LIVER. 
573 
organs and depraves the blood, besides creating an imperiously 
morbid appetite. It has been repeatedly demonstrated that the 
use of such bitters has laid the foundation for a drunkard’s life, 
with all the woe and untold misery which attend it. 
1154. I cannot but animadvert upon (as I regard it) one of 
the most outrageous swindles that has lately been imposed upon 
a credulous and afflicted public. The imposition consists in 
offering a nasty, muddy, drastic cathartic, a fluid mixture of 
aloes and sour beer, and selling it under the guise of temperance 
(?) bitters, purported to be made from the harmless roots and 
herbs of California ! It is extensively advertised to cure “ all 
the ills to which flesh is heir.” In an almanac designed to ad- 
vertise this compound, and liberally distributed throughout our 
land, we read, “ The man who commends the use of any prepara- 
tion containing alcohol, as a medicine, is an incendiary, for all such 
preparations inflame the blood and rapidly consume, the vitality 
of the system.” The National Advocate says, “H. H. Vaughn, 
State Assayer of Rhode Island, submitted to Sheriff Holden a 
report, showing that ‘ this compound had 7.30 per cent, of Al- 
cohol ! ’ ” Henry Gibbons, M. D., read a paper before the Cali- 
fornia State Medical Society, in which he said, alluding to the 
same preparation, “ The truth is that it is rendered more repulsive 
and obnoxious by concealing its poison behind the mask of tem- 
perance. That it contains alcohol there is no doubt. Its harsh 
and drastic properties have given rise to serious injuries in many 
instances within the knowledge of myself and others.” It 
really looks like a shrewd artifice—an advertising dodge—to call 
it a temperance remedy, when analysis clearly establishes that it 
contains over seven per cent, of alcohol! The welfare of society 
demands that such claims be exposed, for “ The man who com- 
mends the use of any preparation containing alcohol as a medi- 
dicine is an incendiary, for all such preparations consume the 
vitality of the system.” Tearing off its temperance mask, we 
say, let it stand or fall according to its self-pronounced judgment. 
1155. Every physician, as well as every intelligent person, is 
aware that aloes acts as an irritant to the lower bowels and pro- 
duces piles and other painful diseases; it should never be given 
unless modified by other medicines, and then only under the direc- 
tion and observation of a skillful physician. Many constitutions 574 
COMMON SENSE MEDICAL ADVISER. 
cannot endure its action, and it invariably produces lasting injury. 
Then to think of the effect that sour beer or vinegar produces 
upon the system ! Every physician knows that it tends to impair 
the vital processes, breaks down the healthy tissues, reduces the 
flesh and, if long continued, it will destroy the strength and vigor 
of the constitution. 
1156. I call attention to this fact, because, with the present 
advance in pharmaceutical knowledge, (the art of preparing me- 
dicinal compounds,) it is unnecessary to add alcohol in order to 
preserve the properties of medicine. With the exception of a 
few drops of liquor necessary to cut a flavoring oil, not a particle 
of alcohol enters into the composition of my Golden Medical 
Discovery or my Favorite Prescription. 
1157. Medicines to be strictly remedial, should exert a tonic 
or restraining influence upon all the vital processes. Those or- 
gans which are contiguous to the liver, or connected by sympathy 
with it, need to be congenially upheld in the performance of their 
functions. People who are habitually subject to “ bilious ” attacks 
are pleased to find that the use of the Discovery and Pellets fur- 
nishes immunity from such onsets, and prevents their usual re- 
currence. Thus these remedies are preventive as well as curative. 
1158. What I have thus far recommended for the treatment 
of this chronic affection is within the reach of every family. Pa- 
tients laboring under this disease, when complicated with other 
affections, require special consideration and treatment, and all 
such are counseled to employ only those physicians whose experi- 
ence and success entitle them to confidence. Health is one of the 
greatest of blessings, and how to restore it when lost, is a ques- 
tion of vital importance. When a decision or choice is made as to 
who shall undertake the treatment, I next advise the exercise of 
patience and persevering trial in the use of the remedies employed. 
1159. Having enjoyed the confidence of thousands of invalids 
who have suffered from this chronic ailment, and have been 
restored to health by my treatment, I can present an abundance 
of testimonials of my success. I prefer, however, to mention 
only a few of the 
CASES TREATED. 
1160. Case I. H. G. writes, “Since I used your medicines, 
as you advised three years ago, I have had but one of those CHRONIC INFLAMMATION OF THE LITER. 
575 
bilious attacks (and that soon after commencing them), which 
previously occurred at least once a week.” 
116]. Case IS. John N., unmarried, aged 27, consulted 
me by letter, in May, 1871. He was very much emaciated, 
countenance sallow, skin yellow, dry and harsh, urine high- 
colored, had palpitation of the heart, poor appetite, headache, 
dizziness, low spirits, nausea, bowels constipated, hacking cough, 
great debility,—in short, all of the symptoms indicating disease 
of the liver. 
I commenced his treatment by regulating his habits, first in 
regard to diet, exercise and sleep. I advised a spirit vapor- 
bath once a week, and an alkaline-bath twice per week. He Avas 
given the Purgative Pellets, to gradually open his bowels, and 
the Golden Medical Discovery, to take according to the direc- 
tions upon the bottle. Six months afterward, he wrote, “ I am 
a well man; all of my bad symptoms are gone. My skin is now 
clear; I feel strong and ambitious, and have gained thirty pounds 
of flesh.” 
1162. Case III. Mrs. Maria M., aged 34, consulted me 
by letter in 1873. She was very much emaciated and quite 
feeble, having been an invalid for nearly a year. Her counte- 
nance was sallow, bowels constipated, tongue furred, and she 
had headache, palpitation, and difficulty of breathing; she 
complained of pain and heat in the loins and back, and of “ a 
dragging down sensation,” causing frequent urination which 
was attended by pain. She had also a leucorrhoeal discharge, 
was often low spirited, sometimes wakeful and sleepless, at other 
times stupid and drowsy. She complained of uneasiness and wan- 
dering pains, and had not only lost her appetite, but suffered 
from nausea. This case had baffled the skill of several physicians, 
who regarded the disturbance of the heart, lungs and uterus, as 
the cause of her ill health. I was soon satisfied, however, that 
her symptoms indicated chronic inflammation of the liver. Her 
nervous system was very weak, owing to the fact that the 
digestive functions were also deeply implicated in the disorder. 
Treatment consisted of gentle and regular exercise daily in the 
open air. I likewise gave advice in relation to her food, and 
directed her to take the acid-bath (®f 645) occasionally. I recom- 
mended the use of the Golden Medical Discovery and Favorite 576 
COMMON SENSE MEDICAL ADVISER. 
Prescription, a teaspoonful of each three times a day. I directed 
her to use Dr. Sage’s Catarrh Remedy as a vaginal injection. 
After four weeks I reduced the medicines, directing the use of 
the Discovery but twice a day, and the Favorite Prescription 
only at bed-time. The Catarrh Remedy was continued as before 
directed. This treatment was persevered in, with slight varia- 
tions, according as the circumstances required, and finally resulted 
in her complete restoration to health. 
1163. Case IV. Peter A., a Southern gentleman, aged 54, 
and married, consulted me by letter in the summer of 1872, stat- 
ing that he was suffering from disease that had long resisted 
the treatment instituted by physicians in the vicinity of his home. 
The symptoms were somewhat obscure and puzzling, if not calcu- 
lated to mislead. He experienced frequent attacks of violent 
headache, was extremely nervous and wakeful, and when this 
passed off he would be stupid and drowsy. He complained of 
pain between the shoulders and in the small of the back, experi- 
enced giddiness, and roaring in the ears. At other times he was 
attacked by paroxysms of violent palpitation, exciting apprehen- 
sions of disease of the heart. His eyes were sometimes dull, at 
others bright,bowels irregular,urine scalding. A microscopical ex- 
amination of the urine revealed the morbid condition of the liver 
and stomach, which through the medium of the pneumogastric 
nerve, had excited the violent action of the heart. The nervous 
system was greatly implicated, symptomatically, in the disorder. 
The treatment was commenced with such hygienic advice and 
regulations as the case demanded. Especial attention was given 
to the condition of the surface, and to regulating the action of 
the bowels. Some special medicines, which proved to be most 
admirably adapted to his condition, were prepared and sent him. 
In one month after the commencement of the treatment the se- 
verity of all his symptoms was greatly ameliorated, and his attacks 
of headache were less frequent and much milder. He continued 
to improve, and in another month was quite free from them, 
and at the end of the third month was entirely cured. After the 
lapse of nearly two years, he wrote that he had experienced no 
return of the symptoms of his former complaint, and that the cure 
was a source of great gratification to himself and a matter of con- 
siderable astonishment to his friends. JAUNDICE. 
577 
JAUNDICE. (Icterus.) 
1164. This affection is generally regarded as a symptom of a 
disordered liver, since it frequently occurs during the progress of 
diseases of that organ. When it imparts a greenish tinge to the 
skin the disease is termed green jaundice, and when a black color, 
it is known as black jaundice. 
1165. Caiise§. In consequence of the varied conditions 
from which it arises, Professor Da Costa has aptly remarked: 
“with the recognition of jaundice the difficulty in diagnosis may 
be said to begin.” He considers the causes of jaundice to be (1) 
diseases of the liver; (2) disease of the bile ducts; (3) diseases 
remote from the liver, or general diseases leading to a disorder of 
that viscus’ (4) certain causes acting upon the blood. Jaundice 
is undoubtedly due to the presence of biliary elements in the 
blood. 
1166. Symptoms. It is usually characterized by a yel- 
lowish color of the skin and of the white of the eyes. The skin is 
usually dry and harsh; if it be moist the linen will be tinged yellow 
from the perspiration. The tongue is coated yellow, the mouth 
is dry, the taste acrid, and the appetite impaired; there is head- 
ache, nausea and sometimes vomiting; pain in the abdomen after 
eating, and in the region of the liver, and it is also felt in the right 
shoulder and between the shoulder-blades. In severe cases there 
is fever accompanied with chills, despondency and loss of flesh. 
The stools are of a light clay-color and very offensive; the urine 
is thick and yellow. When the disease terminates fatally there 
is delirium followed by stupor. 
1167. Treatment. The first indication is to eliminate 
from the system, as speedily as possible, all noxious materials. 
For this purpose the spirit vapor-bath (T 630) should be used. 
If the urine be scanty or voided with difficulty, take acetate of 
potash 569) or queen of the meadow (*f 559). These may be 
taken in connection with my Golden Medical Discovery and Pur- 
gative Pellets, the efficacy of which has already been shown in 
the treatment of chronic inflammation of the liver. They are 
indeed valuable agents in this disease, since they increase the ex- 
cretory power of all the emunctories and rapidly remove those 
matters, which if retained would poison the system. 578 
COMMON SENSE MEDICAL ADVISER. 
1168. In some cases acids are of great value; good hard cider 
or muriatic acid 477) and the acid-bath 645) are frequently 
valuable agents. 
In other cases the employment (both externally and internally) 
of alkalies 473) in addition to the Golden Medical Discovery, 
answers a much better purpose. 
Again, there are those,who in addition to alteratives and baths, 
require tonics. In the treatment of this affection, whatever may 
be the nature of the case, the use of alteratives must not be for- 
gotten, for without them the auxiliary treatment,— acids, alkalies 
and tonics,— will not produce the desired effect. 
1169. The employment of drastic remedies is sometimes 
resorted to; although they may give temporary relief the patient 
soon relapses into his former condition, while if the treatment 
above given be observed, the recovery will be permanent. 
GALL-STONES. (Biliary Calculi.) 
1170. These are concretions found in the gall-bladder or bile 
duct and vary from the size of a pea to that of a hen’s egg. 
There may be no indication of their existence in the gall-bladder 
until they begin to pass through the duct. 
1171. Causes. The formation of gall-stones is, undoubt- 
edly, due to an unhealthy condition of the bile. Corpulent per- 
sons and those indulging in an over-stimulating diet, or in the 
habitual use of fermented drinks, are most liable to be troubled 
by them. 
1172. Symptoms. The patient is suddenly seized with 
excruciating pain in the right side. After a time it subsides, but 
is again renewed with as great severity as before. There is 
nausea, with vomiting, which is often excessive and severe. The 
pulse is sometimes slower than is natural, the extremities are 
cold, there is great exhaustion, together with perspiration and 
spasmodic contraction of the abdominal muscles. As soon as 
one stone has passed through the duct into the intestine, imme- 
diate relief is experienced until another commences to pass, and 
the larger the concretion, the greater will be the pain. If the 
stools be carefully observed and water added to them, the gall- 
stones may be seen floating on the top of the water. 
1173. Treatsnent. This consists chiefly in relieving the CHOLERA. 
579 
patient of pain and vomiting during the passage of the gall- 
stones. Hot fomentations made from stramonium leaves (^f588) 
and lobelia 573) and applied upon the painful parts are bene- 
ficial. Small doses of lobelia may be taken, but not sufficient to 
produce vomiting. Doses of opium 480) may also be taken; 
this anodyne must, however, be used with care. Gelseminum 
510) is often useful. Chloroform, ether, or the spirit vapor- 
bath 630) generally allay the pain. Carbonate of soda 
dissolved in water relieves the vomiting. 
1174. These distressing symptoms are apt to recur until the 
removal of all the gall-stones is effected. To aid in removing 
them, take my Golden Medical Discovery rather freely for a day 
or two and continue its use with lobelia, in doses sufficiently 
large to produce nausea, but not vomiting. From four to eight 
ounces of sweet oil may be given, and if the bowels do not 
respond within three hours, repeat the dose, and the gall-stones 
will be pretty sure to be evacuated. To prevent the formation 
of these concretions take my Golden Medical Discovery together 
with alkaline drinks made of carbonate of soda. Health, tone 
and energy will thereby be imparted to the liver, the free flow 
of bile will be insured and the subsequent formation of gall- 
stones prevented. 
CHOLERA. 
mo. This affection may be classified under the three fol- 
lowing divisions, viz: Epidemic Cholera, Cholera Morbus and 
Cholera Infantum. 
1176. Epidemic Cholera. This plague is not of 
recent date. It first made its appearance on our continent in the 
year 1834. Owing to its great fatality, it is a disease much to 
be dreaded. 
1177. 8ymptom§. These are well defined. It is char- 
acterized in its earlier stages by pain in the stomach and bowels, 
—especially in the umbilical region—nausea, vomiting and diar- 
rhoea; later, the purging is excessive and the matter dejected 
resembles rice-water and contains white, solid, curd-like sub- 
stances. So frequent and profuse are the evacuations, that the 
patient loses strength and sinks rapidly. The secretory organs 
fail to perform their functions normally, the skin is sometimes 580 
COMMON SENSE MEDICAL ADVISEE. 
moist, but oftener cold and dry; but little if any bile is found in 
the excretions and the urine voided is very scanty. There is 
general nervous derangement, as indicated by the spasmodic con- 
traction or cramping of the muscles. This first attacks the 
extremities, but soon pervades the entire body and gives rise 
to excruciating pains. The head is affected by singing, roaring, 
disagreeable noises in the ears, the pulse is feeble but quick, the 
nails are of a bluish color, the tongue is coated white, the 
eyes are sunken and the patient has a ghastly look; the tempera- 
ture of the body rapidly falls, the surface, becomes deathly cold, 
and unless the disease be promptly arrested in its course, speedy 
dissolution follows. The disease is rarely prolonged beyond 
twenty-four hours and sometimes terminates within three or 
four after its first attack. 
1178. Causes. There are various opinions with regard to 
the causes of this disease. Some writers hold to the theory pro- 
pounded by Dr. Guernsey, who says: “That cholera is induced 
by a special poison, and that this poison is of foreign extraction, 
reaching our shores and extending from point to point by means 
of direct human intercourse, by positive or individual contagion, 
or sweeping from point to point from some of its great breeding 
centers, by a kind of wave-like extension.” Others have sup- 
posed cholera to be caused by animalcules floating in the 
atmosphere, in certain infected districts, and that these have 
been introduced into the system. Others have attributed it to 
the atmosphere being unduly charged with ozone. It is evidently 
due to miasmatic influence, and it is generally admitted that 
the existing causes are due to atmospheric influences—a warm, 
damp air corrupted by the gases escaping from decaying vege- 
table or animal matter. The use of indigestible articles of food 
may also conduce to the establishment of this disease. 
1179. Treatment. The kind of medicine required, de- 
pends upon the severity of the attack and stage of the disease. 
In all cholera epidemics, there are premonitory symptoms, such 
as an uneasy sensation at the pit of the stomach, and a rumbling 
of the bowels. This is apt to be followed by a painless diarrhoea, 
which occasions no alarm, and the patient pays but little atten- 
tion to it. Herein is the great and dangerous mistake. The 
patient is already in the stage of invasion, which must be CHOLERA. 
581 
promptly arrested, or he will suddenly be precipitated into the 
stage of collapse. What now' is the indication of treatment? 
Let the patient lie dowrn, and have placed about him bottles 
filled with hot water, w7ith a hot stone or brick at his feet, 
thereby exciting warmth upon the surface of the body. At the 
same time administer two teaspoonfuls of my Extract of Smart- 
Weed. If the symptoms be urgent, repeat the dose every fifteen 
minutes. Brandy thickened writh crushed sugar may also be 
given. In either the stage of invasion or collapse, the leading 
indication is to establish reaction by promoting perspiration. 
Bathe the feet in water as hot as can be borne, give the Extract 
of Smart-Weed freely (the patient lying down and being thor- 
oughly covered), and thus endeavor to excite a profuse, warm 
perspiration, which will immediately arrest the invading stage of 
cholera, and save the patient’s life. No time should be lost, for 
delays are dangerous. The work must be done expeditiously, or 
death will ensue. When reaction is established, the patient 
should remain quiet and not attempt to use his strength. To get 
up too soon, invites a return of the disease. 
1180. In the stage of collapse, the discharges from the bowels 
are thin and watery, like rice-water, vomiting sets in, thirst and 
cramps follow, the skin is blue, the eyes sunken in their sockets, 
and the pulse is scarcely perceptible. If perspiration can be 
established, it reverses all of these symptoms. Wrapping the 
patient in a woolen blanket, and placing fifteen or twenty ears 
of boiled corn, hot from the kettle, next to the blanket, will 
steam and sweat him as quickly and thoroughly as any external 
application can. This measure, used in conjunction with my 
Extract of Smart-Weed, will often save the patient, even after 
the stage of collapse has set in. After reaction has taken place, 
the perspiration should be gently continued for twelve hours, 
and the patient may take slippery-elm tea, toast-water, and par- 
take sparingly of soft toasted bread and chicken-broth. The 
food may be fluid and nutritious, but must be taken in small 
quantities. Do not disturb the bowels with laxatives until the 
third day after the amendment of the patient, and then it is 
better to move them by an injection of warm water. Great care 
must be taken that the patient does not indulge too soon or too 
freely in the use of food. When a skillful physician can be had, 582 
COMMON SENSE MEDICAL ADVISER. 
no time should be lost in securing his valuable services, but since 
in epidemics of this nature, medical men are generally over- 
worked, and not always easily and promptly to be had, I have 
been quite explicit in giving full directions for treatment. 
1181. Clioler?! [Summer Complaint). This 
form, also known as sporadic cholera, bowel complaint, etc., usu- 
ally occurs during the summer months. The attack may be 
sudden, although it is usually preceded by a sensation of uneasi- 
ness and colic pains in the stomach. 
1182. Symptoms. These are nausea, vomiting and pur- 
ging. The discharge from the bowels is at first of a thin, yellow 
appearance, but finally it becomes almost colorless. Sometimes, 
after the contents proper of the bowels have been evacuated, the 
dejections have a bilious appearance. Severe cramps and pains 
are incident to vomiting. The vomiting and purging usually 
occur in paroxysms, but finally they become less frequent, a re- 
action takes place, the extremities grow warm and the patient 
gradually recovers. It may be accompanied by intense thirst 
and a quick pulse, yet the surface may be cool, with general 
symptoms of internal fever. 
1183. Cilfises. Cholera morbus is more prevalent in warm 
than in cold climates, and especially in malarial districts. It is 
generally the result of eating indigestible articles of food, as un- 
ripe fruit, uncooked vegetables, etc. Stimulating drinks, or those 
articles which furnish the elements for fermentation, are also 
favorable to the production of this disease. 
1184. Treatment. If the attack be superinduced by 
eating unripe or stale fruit, it may be proper to give an emetic 
570) or a cathartic (*[ 533), but ordinarily first give a full 
dose of my Extract of Smart-Weed 486), and if the ejections 
be very sour let the patient have a weak alkaline tea, which may 
be made by dropping a few live, hardwood coals into a tumbler 
of water. This will not only assist in neutralizing the acidity of 
the stomach, but help to allay the thii*st and accompanying fever. 
If the patient throws up the first dose of the Extract of Smart- 
Weed, let another be given. Do not allow the patient to drink 
cold water, and give only tablespoonful doses of the alkaline 
solution every thirty minutes. If the thirst be great, occasion- 
ally give a tablespoonful of a tea made from scorched Indian CHOLERA. 
583 
meal, which will not only allay the desire to drink, but also settle 
the stomach. Or what is better, if at hand, give a tea made by 
steeping the leaves or bark of the peach tree 599) in water for 
a few minutes. The patient should be well covered in bed and 
kept warm and sweating. Hot fomentations applied to the bow- 
els are very valuable. When these attacks are promptly treated 
as I have suggested, the patient will, generally, quickly and com- 
pletely recover from them. If, however, they do not yield to 
these measures, the family physician should assume the respon- 
sibility of the treatment. 
1185. Cholera Infantum, otherwise known as the 
summer complaint of children, has been by some regarded as be- 
longing exclusively to America. It has been ascertained, how- 
ever, that this disease prevails in Europe, where it is called by a 
different name. It usually attacks children under four years of 
age, and generally between the months of June and October. 
1186. Symptoms. There is at first diarrhoea and the 
stools are sometimes of a watery, colorless consistence; at others 
they have a greenish-yellow appearance; the pulse is quick, the 
head and abdomen are hot, while the limbs are cold. The child 
seems to suffer more or less pain, as indicated by its crying, and 
frequently screams as if suffering acutely. The disease often 
terminates unfavorably and sometimes within a few hours; again, 
it continues for several weeks, and the little sufferer becomes 
very much emaciated, his eyes sunken, countenance pale, and yet 
a recovery is possible. 
1187. Causes. From the fact that it oftener occurs 
during the summer months than at any other time of the year, it 
may be inferred that the temperature greatly influences the pre- 
valence of this disease. It more frequently attacks the poorer 
classes, or those living in unhealthy sections, although the chil- 
dren of the wealthy are likewise subject to it. Teething, change 
of diet at the time of weaning, and unhealthy, diluted milk, 
may be the exciting causes of this disease so common to children. 
1188. Cholera infantum is more prevalent in our large cities, 
it being comparatively unknown in rural districts. Often these 
little sufferers are greatly improved by a trip into the country or 
to the sea-shore. Pure air and fresh sweet milk, as hygienic and 
dietetic adjuncts, are necessary for recovery. 584 
COMMON SENSE MEDICAL ADVISEE. 
1189. Treatment. The first treatment should be pre- 
ventive. The little patient should be placed in a well ventilated 
room. Next, attend to the diet, and ascertain if the milk be 
pure and healthy. If the child nurses, then the mother should 
properly regard her diet. She should not eat unripe or stale 
fruits or vegetables, but her food should be nutritious and easily 
digested. She should not overwork, nor heat her blood, neither 
should she allow herself to become excited and irritable. She 
should occasionally give the child some mild alkali to obviate 
undue acidity of the stomach. Scalding the milk, or using a 
little lime-water in it, is sometimes beneficial. The following 
can be obtained at almost any drug store. Syrup of rhubarb 
two ounces, lime-water four drachms, (about four teaspoonfuls) 
and water of peppermint two drachms. Give of this mixture, 
to a child one year old, one teaspoonful every hour until it oper- 
ates on the bowels as a laxative, which may be known by the 
changed appearance of the passages. Follow this with small 
doses of my Compound Extract of Smart-Weed and cover the 
bowels with cloths wet with the same. This treatment I have 
employed with perfect success in my own family and also with 
the same uniformly happy results in the general practice of med- 
icine in which I was engaged for several years before confining 
my practice exclusively to chronic diseases, as I have done for 
some years past. 
WORMS. 
1190. That the human body should form a habitation for 
these disgusting creatures, is a source of annoyance and humilia- 
tion. Their existence is a matter of common observation and 
experience, but their origin is still obscure, notwithstanding an 
endless amount of discussion and theorizing. It would not 
accord with the limits of this work, to discuss the numerous 
theories which have been offered, to account for the presence of 
these parasites in the human system. I shall enumerate the 
principal species, describe the symptoms revealing their presence, 
and prescribe the proper remedies. 
1191. There are five species of intestinal worms, each suffi- 
ciently common to merit a separate description. 
1192. (1.) A round worm, varying from six inches to a foot 
in length, and resembling the common earth-worm, is termed by WORMS. 
585 
naturalists, the ascaris lumbricoides. It infests the small intes- 
tine and seldom migrates into the stomach or large bowel. 
Instances are recorded, however, in which it has crept upward 
into the oesophagus, larynx, nostrils and eustachian tube; but 
their presence in these parts is of rare occurrence, and is generally 
caused by some local irritation which compels their migration. 
The fact that they have been found in the peritoneal sac, gave 
rise to the opinion that they had perforated the intestine; but 
careful observations have proved that they can only escape 
through openings made by ulcers. 
This species has been found in adults, but is more common in 
children from three, to ten or twelve years of age. The num- 
ber of this species existing in a human body is variable. Some- 
times only two or three are found. At other times a hundred, 
and even twice that number, are voided in a few days. 
1193. (2.) The ascaris vermicularis, thread, pin, or seat-worm, 
is round, very slender, and about half an inch in length. The 
habitation of this species is the rectum, and they are often found 
matted together in the excrement. They are very active, even 
after ejection, and have been known to cause great local irritation 
by entering the vagina and urethra. This is an occasional cause 
of masturbation. It is impossible to estimate the number of 
these parasites that may exist in the human rectum. Great 
numbers sometimes are voided at a single evacuation. 
1194. (3.) The tricocephalus dispar is a third variety of the 
round worm, and is said to infest the bodies of almost every 
species of mammalia. As its name indicates, the upper portion of 
its body is slender, hairlike, and terminates at the lower extremity 
in a thick spiral portion. It is from one to two inches in length, 
and is found attached by its head to the mucous membrane of 
the caecum 52, Fig. 29), and in rare instances, in the colon 
and small intestine. They are never numerous. 
1195. Tcenice, or tape-worms, are hermaphrodites (T 271), of 
a flat, ribbon-like form, and composed of numerous segments, 
each of which is provided with a complete set of generative 
organs, and contains ova for the production of thousands of 
individuals. Some authors have supposed that each segment, or 
joint, was a distinct individual, but the existence of one head for 
the whole, precludes this theory. There are two species of 586 
COMMON SENSE MEDICAL ADVISEE. 
toenice developed in the human intestine, viz: the taenia solium 
and the taenia lata. 
1196. (4.) The taenia solium is the species commonly found in 
America and all the countries of Europe, except France, Russia, 
and Switzerland. In France, both species are found, but the 
taenia lata seems to be indigenous to Russia and Switzerland. 
1197. The taenia solium varies in length from four or five to 
thirty, thirty-five or even forty feet. The head is hemispherical 
and armed with a double row of twenty or thirty hooklets. The 
genital organs are alternate and placed upon the outer edges of 
each segment. It inhabits the small intestine and is usually 
solitary. 
1198. (5.) The taenia lata (broad tape-worm) is distinguished 
by the greater breadth of its segments, and the location of the 
genital organs, which are found in the centre of each segment. 
Its small elongated head is unarmed and has a longitudinal fissure 
on each side. It usually attains a greater length than the taenia 
solium. 
1199. Hyill|9tosn§. The symptoms which the long worms 
give rise to, are many times somewhat obscure. Thirst, irregular 
appetite, colic pains, excessive flow of saliva, enlargement of the 
abdomen, itching of the nose, pallor, offensive breath, disturbed 
sleep, and grinding of the teeth, are all common symptoms. Occa- 
sionally convulsions and other nervous affections are produced by 
the presence of the ascaris lumbricoides, but generally they pro- 
duce less constitutional disturbance than the other varieties. The 
passage of lumbrici from the bowels and their ejection from the 
stomach is frequent, and is the only positive evidence of their 
presence. The ascaris vermicularis, thread, pin or seat-worm, 
gives rise to most of the symptoms produced by the long worms, 
but in addition produces intense itching at the anus, and not un- 
frequently there will be seen an eruption upon that part. The 
itching is particularly distressing at night. When the little suf- 
ferer is well covered, the warmth occasioned by the bedclothes 
causes these little parasites to crawl out upon the anus, and pro- 
duce such paroxysms of itching and pain as to cause the child to 
kick the covering, off and lie naked, thus getting relief by driving 
the worms back into the bowels by exposing them to the cold 
atmosphere. The persistent manifestation of this disposition to WORMS. 
587 
lie naked, should excite the parents’ suspicions of seat-worms, and 
lead them to investigate all the symptoms. By examining the 
child’s stools the worms may be found adhering to the faeces, and 
they may also be seen on the anus. Thousands of children suffer 
untold agony from these little seat-worms, which are left unmo- 
lested to torment them, because the parents are unfamiliar with 
the purport of the symptoms manifested, and therefore pay no 
heed to them. I have been thus particular in describing the 
symptoms indicating the presence of these pestiferous parasites, 
in order that they may be readily detected. Parents can apply 
the remedy, and sparkling eyes, happy faces and joyous spirits 
will unconsciously express the gratitude of thousands of little 
ones, not only to them, but to the benefactor who was indirectly 
instrumental in relieving their sufferings,—grateful incense from 
the altar of life,— an invaluable benediction, which more than 
compensates for the weariness and toil incident to the task of 
writing and publishing this volume. I certainly could desire no 
higher honor or greater distinction than to be considered the 
“ friend of children.” 
1200. The Symptoms produced by the tape-worm are dizzi- 
ness, ringing in the ears, increased secretion of saliva, indigestion, 
ravenous appetite, sharp abdominal pains, and emaciation. The 
only positive sign of the presence of these parasites is the passage 
of pieces of them in the faeces. The nervous and other symptoms 
produced by the ordinary long worms are also common symptoms 
of the tape-worm. 
1201. Causes. Careful observations have proved that 
there are certain causes which favor the generation or develop- 
ment of intestinal worms. Among others, we may mention all 
fatty or farinaceous articles of food, gormandizing, constant 
exposure to a moist atmosphere, and sedentary habits. 
1202. It is now generally conceded that the development of 
tape-worms is due to the ingestion (swallowing) of an egg or 
germ-cell, which is contained in many kinds of animal food, as 
pork, raw beef, etc., and which the process of cooking has failed 
to destroy. People living near low marshes, lakes, or the sea- 
coast, are peculiarly liable to tamice. 
1203. Treatment. The expulsion of the ascaris lum- 
bricoides may be very easily and pleasantly effected. Santonin 588 
COMMON SENSE MEDICAL ADVISER. 
(If 488) is a specific remedy for this variety of worms. For a 
child three years old, take santonin six grains, podophyllin one 
grain, white sugar thirty grains; mix, triturate, and divide into 
twelve powders, and give one every three or four hours, until 
they act upon the bowels. Or, take santonin ten grains, white 
sugar twenty grains; mix, triturate, and divide into ten powders, 
and give one every night on the child’s retiring, and after giving 
two or three in this way, administer a mild cathartic. As san- 
tonin is almost entirely tasteless, if not combined with other 
medicines which are unpalatable no difficulty will be experienced 
in administering it to children. By reference to the article on 
Anthelmintics in this volume (If 487), other valuable vermi- 
fuges may be selected, and directions found for their employment. 
1204. In the removal of thread or pin-worms, anthelmintic 
medicines taken into the stomach are of little or no value. An 
injection of a strong solution of salt is a very efficient remedy. 
A teaspoonful of turpentine in half a pint of milk makes a good 
injection. Strong coffee has been recommended as an injection. 
The anus should be well anointed with lard, oil or fresh butter 
after each movement of the bowels. Whatever injection or 
remedy is used, it must be followed by the use of some oint- 
ment to the anus, otherwise they will continue to lay their germs 
about that orifice and multiply there. 
1205. Various remedies have been used to destroy tcenice, 
(tape-worms). Among others I may mention the old and time- 
honored remedy which consists of two or three ounces of the oil 
of turpentine, taken in castor oil or some aromatic tincture. 
A decoction made by boiling two or three ounces of fresh 
powdered pomegranate bark in a pint of water was used by the 
ancients and is now highly recommended as a remedy. 
Some American physicians have used an emulsion of pumpkin 
seeds with marked success. 
Twenty or thirty grains of the extract of male fern (II 493), 
followed by a cathartic is highly recommended for the destruc- 
tion and removal of taeniae. 
TRICHINA SPIRALIS. 
1206. In 1835, Owen discovered a peculiar parasite which 
sometimes infests the human muscles, and is termed the trichina CONSTIPATION. 
589 
spiralis. The presence of these parasites has given rise to 
morbid conditions of the system attended by the most serious 
results. They are developed in the alimentary canal and then 
perforate its tissues and enter the muscles. Twelve trichinae 
have been found in a section of human muscle only one-twelfth 
of an inch square and one-fifth of an inch in thickness. Many 
instances of death from trichinae have been reported in New 
York, Boston, Chicago, Cincinnati, St. Louis, and many minor 
cities and towns of America. 
1207. The early symptoms of trichime are very uncertain, 
being the same as those of other diseases. The patient com- 
plains of severe pain in the abdomen and is troubled with 
diarrhoea. When the trichinae pass into the muscles they occa- 
sion great suffering. There are sharp pains in the muscles, the 
perspiration is profuse and the patient becomes exhausted. 
1208. Cause. Nearly every case of trichinae which has 
been brought to the notice of the profession was attributed to 
the eating of raw or improperly cooked pork. The parasites can 
only be detected by the microscope. 
1209. Treatment. The impossibility of removing the 
trichime after they have passed into the muscles is obvious; and 
as yet no special remedy has been recommended to remove them 
from the alimentary canal. The only safety lies in prevention. 
Hence all raw or imperfectly cooked pork should be avoided. 
1210. Health depends very largely upon the regular activity 
of the bowels. Each day there should be proper alvine evacua- 
tions. There are few persons who have not suffered from 
constipation of the bowels. Inattention to the. calls of nature, 
or a neglect to regularly attend to this important duty, will, 
sooner or later, produce disastrous results. Furthermore, it is 
essential to the comfort of every individual, for when this duty 
ismot performed there is derangement of the mental as well as 
bodily functions; yet many people unconsciously acquire the 
habit of neglecting these calls, and obey them only when they 
are imperative. 
CONSTIPATION. (Costiveness.) 
1211. Constipation, or costiveness, as it is sometimes termed, 
is a functional disorder of the large intestine. This intestine is 590 
COMMON SENSE MEDICAL ADVISER. 
about five feet in length, and consists of the caecum, colon and 
rectum (*[52, Fig. 29). It serves as a temporary reservoir for 
the excrementitial residue of alimentary mattei’, otherwise, the 
act of defecation would necessarily be more frequent. It is dis- 
tinguished as the large intestine, because of its great capacity. 
In Fig. 29, the numerals 5 and 6, represent the caecum and the 
ascending colon. By observing their position we perceive that 
the contents are propelled, in opposition to gravitation, until they 
reach 7, which represents the transverse colon. That there is a 
diminution of muscular power of the large intestine, compared 
with the increased volume, and also detention of the intestinal 
contents due to gravity, are sufficient reasons for the slow pro- 
gress of the faeces, and their great liability to be retained until 
decomposition takes place. 
1212. Habitual constipation produces many disorders, result- 
ing from sympathy, irritation, or mechanical obstruction. By 
referring again to Figs. 29 and 34, the reader may observe the 
anatomical relations which the large intestine sustains to the 
other abdominal organs. The ascending colon arises in the 
caecum (Fig. 29), at the lower part of the abdomen, and passes 
over the kidney on the right side, when it takes a circuitous 
route around the abdominal cavity, comes in contact with the 
inferior surface of the liver, proceeds behind and below the large 
curvature of the stomach, emerges on the left side, and passes 
downward in front of the left kidney, where it dips into the 
pelvic cavity, and forms the commencement of the rectum. 
From being in contact with several important structures, as the 
kidneys, liver, duodenum, spleen, stomach, pancreas, etc., its 
irritation may easily be communicated to them, and thus disturb 
their functions. 
1213. If faecal matters be retained until they are decomposed, 
great injury follows, since the fluid portions are absorbed, con- 
veyed into the blood, and, of necessity, corrupt it with their 
impurities. In this way, constipation may be the source of gen- 
eral disorder, but such disorder is seldom attributed to the torpid 
state of this intestine. There is little doubt but that it thereby 
imposes a great tax upon the functions of the liver, and often- 
times that organ is improperly blamed for the faulty action of 
the large intestine. It is sometimes the case that the blood CONSTIPATION. 
591 
becomes so charged with faecal fluids that their odor can be 
detected in the breath of the patient. 
1214. An overloaded condition of the large intestine may 
cause inflammation of the liver or dropsy of the abdomen. 
When the colon is distended, it becomes a mechanical impedi- 
ment to the free circulation of the blood in other organs, congests 
the portal system, and disposes to chronic inflammation or cir- 
rhosis of the liver. This latter is a structural affection of that 
gland, and may, in turn, give rise to peritoneal dropsy. In a 
word, the accumulation of faeces in the colon irritates both the 
large and small intestines, thus causing congestion of the bowels, 
liver, kidneys, or stomach. 
1215. The protracted presence of feculent matter deadens the 
sensibility of the intestine, so that great stimulation is required 
to provoke it to action. The contents become dry, solid, knotty 
and hard, very difficult to evacuate. If drastic, irritating physic 
be taken, only temporary relief will be afforded, and it must be 
repeatedly resorted to, and the doses increased, to obtain the 
desired effect. 
1216. Symptoms. One diagnostic symptom of a loaded 
state of the colon, is an abundant secretion of urine, limpid as 
water. The direct symptoms relate to the hardness of the faeces 
and the great difficulty of voiding them. The influence of con- 
stipation upon the functions of the liver, is indicated by the sym- 
pathy displayed between that organ and the mind. The patient 
manifests apprehension, depression, gloom, taciturnity and melan- 
choly, all indicative of hypochondriac dejection, induced by con- 
stipation. 
1217. I have treated patients, who, from this cause, had 
renounced their bright hopes, yielded their buoyant sjhrits, and 
becoming subject to superstitious fears, had given themselves by 
night and day to devotions, confessions and penance to appease 
the wrath of a supposed offended deity. True penitential feeling 
arises from the presentation of truth, conviction is increased there- 
by, and a sense of moral obligation. This truth is addressed to the 
understanding and emotive faculties, and is accompanied by spir- 
itual agencies which may influence the determination and after life. 
It often happens, however, that the victims of these deep dejec- 
tions and morbid feelings of self-abasement, are persons not only of 592 
COMMON SENSE MEDICAL ADVISER. 
good moral character, but of high religious attainments, and their 
painful exhibitions of fear, distrust and gloom, originate in phys- 
ical rather than in spiritual causes. It is interesting to witness 
this strange perversion of the imagination, this morbid abasement 
of the religious faculties, and dejection of mind, due to causes dis- 
turbing the functions of the liver and other vital organs. 
1218. Young girls, as they approach the puberal age, seem 
literally possessed with the false idea that the infrequent action 
of the bowels is a desirable habit. They do not associate with 
the duty a proper regard for health, but somehow treat it as a 
“ dernier ressort,”—a practice inelegant and repugnant. The con- 
sequence is, that at this susceptible period, constipation, induced 
by false notions and neglect, arouses a latent hepatic, or pulmon- 
ary disorder, or some other morbid devil that has been lurking 
about their diathesis, ready to perpetrate a “ coup d'etat, when- 
ever favored by such propitious circumstances. This ambush of 
disease, or predisposition to derangement, might never have been 
awakened but for neglect. 
How many girls illustrate the truth of this statement by their 
complaints of giddiness, beating and throbbing pain in the fore- 
head and temples, flushing of the face, transient flushes of heat 
over the whole body, while at the same time the extremities are 
cold ! At other times they may manifest it by their stupor, 
drowsiness, and dead, heavy sleep; and upon arising in the morn- 
ing they are still tired and unrefreshed. 
1219. The constipated condition of the colon often leads to 
congestion of the uterus and leucorrhoea, followed by uterine 
debility, prolapsus, excessive menstruation, obliquities, antever- 
sions or retroversions of that organ. The infrequency of the 
habit, once mistakenly supposed as desirable by the young Miss, 
becomes nearly, if not quite disastrous, to all her desires and 
bright prospects. Complication succeeds derangement, until 
neither the inexperienced girl nor her solicitous and afflicted 
parents know where to look for remedial aid, or to whom they 
may go to unburden their afflictions. If they seek an asylum 
from these sufferings, they find many private institutions, where 
flattering inducements are held out of speedy recovery. At sucli 
institutions, these uterine disorders are treated merely as local 
diseases, while the causes, such as we have described, are CONSTIPATION. 
593 
overlooked, and consequently, a permanent cure is not effected. 
Having spent nearly all the money at her command, the patient 
returns home entirely disheartened. After such failures, many 
of these unfortunate invalids have applied to me and received 
treatment, and by persistently following my directions, have in 
due time been restored to health, amid all the comforts of home 
and dear friends, who rejoiced with them in the unexpectedly 
favorable turn of affairs, accomplished at a comparatively trifling 
expense. 
1220. I have seen infants, and also children one and two years 
of age, in whom constipation was obstinate. It therefore would 
appear that it may be hereditary. In some persons this affection 
continues from childhood, with but little variation, until, before 
reaching their majority, bleeding pile tumors are developed. 
Habitual constipation of the bowels during a period of twenty 
years, will generate a class of diseases which are very serious in 
their results. 
1221. Causes. I have already alluded to a sense of false 
delicacy, which prohibits a response to the calls of nature, and 
I may mention other reasons, equally trifling, which prevent 
many from meeting her demands. Some are in the habit of 
temporarily postponing their visits to the water-closet, until, 
when they do go, they find that their efforts are not seconded by 
nature. Sometimes the closet is a damp, uncomfortable out- 
house, situated at a distance from the dwelling, or the access is 
too public, and hence there is an unwillingness to resort to it at 
the proper time. Some appear to be too indolent to attend to 
this duty, or are too deeply interested in the story which they 
are reading. Others are too ambitious, and cannot take the time, 
but must finish some self-imposed task, or attend to a pressing 
engagement, before meeting this physical demand. Thus there 
is a large class of delinquents who procrastinate this duty, until 
they are urged by an imperious necessity. 
1222. When persons who are very sensitive are visiting or 
traveling, if they do not perceive the conveniences and suitable 
opportunities for such a private resort, are deterred by diffidence 
or a false delicacy, from communicating their wants to others, 
and obtaining necessary relief. 
1223. Inactive life and sedentary occupations are also causes 594 
COMMON SENSE MEDICAL ADVISER. 
of constipation. Active exercise promotes all the bodily func- 
tions and helps to make the bowels regular. Those who are 
engaged in literary pursuits, find that mental occupation deter- 
xxiines the blood to the brain, thus drawing it from the extremi- 
ties; the temperature falls below the natural standard, and there 
is almost invariably congestion of the bowels. The inmates of 
boarding-schools, also factory-girls, seamstresses, milliners, em- 
ployees in manufacturing establishments, those who work by 
the “piece,” and all who sit and toil almost unremittingly twelve 
hours in the day, do not get sufficient exei-cise of all the muscles 
of the body, and are often troubled with obstinate constipation. 
1224. Our diet, prepared after the modern modes of cookery, 
is one of the causes which contribute to this ailment. People 
live too exclusively upon superfine wheat flour. The branny 
portion of a kernel of wheat consists of various nutritive ele- 
ments, with more than five times the amount of carbonate of 
lime contained in superfine flour. Silica, too, is interwoven 
in its fabric, and so united with its nourishing constituents, that 
when all are subjected to the action of the intestinal juices they 
become remarkably bland, soothing and naturally stimulating to 
the action of the colon, showing that they are well adapted to 
overcome costiveness. There is very little residue from super- 
fine flour, and it becomes dry, hard and uncongenial to the in- 
testine. Those who daily use boiled cracked wheat find that the 
bowels are easy when digesting it. There is no dryness ox- 
hardness of the faeces and the intestine is evacuated without 
discomfort. 
1225. Treatment. Prevention is always better than 
cure; hence, a few hygienic directions may not be amiss. (1.) 
Do not disregard the intimations of nature, but promptly 
attend to her injunctions. Do not neglect evacuation until the 
blood is infected by the absorption of faecal fluids, which taint 
the breath and vitiate the secretions. If there be costiveness, 
overcome it by establishing the habit of making daily efifyi-ts to 
effect a movement of the bowels, for they are very responsive 
to the volitions. (2.) Taking regular exercise by walking and 
lightly percussing or kneading the bowels for five minutes daily, 
will help to increase the activity of the colon. (3.) The habit of 
early rising favors the natural action of the bowels. (4.) The CONSTIPATION. 
food* should be such as will afford a soft, genially stimulating 
residue, to excite the mucous secretion of the colon and arouse 
its mucles to action. For this purpose there is no one article 
that excels coarsely cracked boiled wheat. Graham bread, 
mush, cakes, gems, and all articles of diet made from unbolted 
wheat flour, are valuable auxiliaries, and may be prepared to 
suit the taste. (5.) Have the meals at stated hours; be punc- 
tual in attendance, regular in eating and thoroughly masticate 
your food. Irregularity in the intervals between eating disturbs 
the functions of the intestine. (6.) The use of ripe fruits, as 
apples, pears, grapes, figs and prunes, in proper quantities and 
at meal-time, are sometimes very beneficial. Trivial or unim- 
portant as these hygienic suggestions may appear, yet were they 
observed, constipation, as well as most of the diseases incident 
to it, would be obviated. A large proportion of the cases will 
yield to the foregoing hygienic treatment without the employ- 
ment of medicines. Should it be necessary, however, to employ 
an aperient to relieve the constipation, my Golden Medical Dis- 
covery will act most congenially, and will be followed by no 
constipating reaction, which invariably occurs when drastic 
cathartics are employed. Its operation is mild, bringing about a 
healthy action by promoting the biliary and other secretions, 
thus aiding nature in establishing normal functional activity in 
the bowels. Recourse should be had to it before employing any 
thing more strongly cathartic. Should it prove, however, too 
mild in its aperient effects, small doses of my Pleasant Purga- 
tive Pellets may be employed daily to assist it. Unlike other 
cathartics, they produce a secondary tonic effect upon the bowels 
which renders their influence more lasting than that of other 
purgatives. I cannot too strongly discourage the injurious cus- 
tom which many people have of frequently scouring out their 
bowels with strong cathartics. It is a bad practice and cannot 
fail to do injury. The greatest benefit is derived, not from 
cathartic doses, but from taking only one or two of the Pellets 
per day, or just enough to keep the bowels regular, and contin- 
uing their use for several weeks, in connection with that of my 
Discovery, strictly carrying out the hygienic treatment hereto- 
fore advised. 
1226. The medical treatment of individual cases sometimes 596 
COMMON SENSE MEDICAL ADVISER. 
involves many considerations relative to the particular circum- 
stances and complications presented. The peculiar susceptibility 
of the constitution, as well as the diseases incident to constipa- 
tion, have to be taken into the account. Symptomatic disorder 
should not be treated as primary, as is frequently done by inex- 
perienced physicians. If the patient be afflicted with uterine 
diseases, piles, nervous affections, falling of the lower bowel, 
fistula, or strictures, they should be well considered and treated 
in connection with this disease. For these reasons I would 
advise my readers to submit all complicated cases, or those which 
do not yield to the course heretofore advised, to the remedial 
guidance of a physician of large experience in the management 
of chronic diseases, and not assume the great responsibility and 
the dire consequences which are very liable to arise from the 
improper treatment of such cases. 
PILES. (Hemorrhoids.) 
1227. There are few maladies more common than this, and 
few which are more annoying. Piles consist of tumors formed 
within the rectum and about the anus, by dilatation of the hem- 
orrhoidal veins and the thickening of their walls. Sometimes, 
wdien attended by considerable inflammation, or when the attacks 
are very frequent, there is thickening of the adjacent cellular 
and mucous tissues. 
It may not here be out of place to remark, that considerable 
confusion prevails regarding this malady, arising from the mis- 
taken popular notion, that all affections of the rectum and anus 
are piles; when the facts are, that these parts are liable to a 
variety of diseases. 
1228. Piles, however, are usually divided into two varieties, in- 
ternal and external, according to the location; and they are called 
bleeding or blind, according to the presence or absence of hem- 
orrhage. In some instances these tumors occur suddenly, but 
usually they are of slow and irregular growth, advancing and 
receding from time to time, but with each successive return 
steadily increasing in size. Both varieties differ very much in 
size, as well as in the suffering they cause. In some instances, 
merely slight twinges of pain are felt, while in others, the agony 
is of the most intense and excruciating character. PILES. 
597 
1229. External Piles. This is the most frequent va- 
riety, and, as shown in Fig. 151, is seated at the verge of the 
anus. They vary in number from one to 
several, and in size from a pea to a pig- 
eon’s egg. They are usually occasioned 
by the rupture of the hemorrhoidal vein 
and the extravasation and coagulation of 
blood into cellular tissue, which at this 
point is partly covered by skin, and partly 
by mucous, membrane. They are liable 
to occur at nearly all periods of life, 
though it is believed by some authors 
that males are less liable to them than 
females, until after puberty, when the reverse is the case. 
Fig. 151. 
External Piles. 
1230. Internal Piles differ from the preceding variety 
essentially in their structure, being mainly composed of collec- 
tions of veins and small arteries, which are in an enlarged or 
dilated condition, and bound together by cellular tissue, which is 
more or less indurated. The tumors thus formed are covered by 
the mucous membrane lining the rectum, into which they project, 
as is shown in Fig. 152. The walls of these 
tumors are liable to become thin and weak, 
and on slight causes give way, and then 
hemorrhage occurs. The location of this 
variety is within the rectum, at a distance 
varying from one-fourth to two and one- 
half inches. Usually more than one is pres- 
ent at a time. The size varies from a pea 
to a large walnut. They are usually moist, 
slimy, of a light florid color, from which 
they vary to a dark blue, purple or livid, 
owing to the condition of the thin vessels. 
During defecation they protrude beyond 
the anus, dragging the gut dowm with them, as shown in Fig. 
153, and are thus productive of great suffering. They seldom 
occur until after puberty, when they ai*e of frequent occurrence 
in both sexes. 
Fig. 152. 
Internal Piles. 
1231. Causes. Anything that will irritate the lower por- 
tion of the large intestine, cause a determination of blood to the 598 
COMMON SENSE MEDICAL ADVISEE. 
pelvis, prevent the return of blood from the hemorrhoidal veins, 
or produce congestion or dilatation of them, may induce piles. 
Whatever occasions one variety, may give rise 
to the other. It is in accordance with the 
above principles that the following causes, to 
wit: habitual constipation, pelvic tumors, ex- 
cessive sexual indulgence, violent horseback 
exercise, unnatural development of the hem- 
orrhoidal vessels, sedentary habits, indigestion, 
pregnancy, straining at stool, habitual use of 
drastic cathartics, diarrhoea, dysentery, sitting 
on heated cushions, long-continued standing 
posture, diseases of the liver, worms, stone in 
the bladder, stricture in the urethra, enlarged 
prostate gland, wearing corsets, eating highly 
seasoned or indigestible food, using alcoholic stimulants, etc., 
are capable of producing piles. And some authors believe that 
in many persons they are hereditary. 
Fig. 153. 
Internal Piles, pro- 
truding. 
1232. Symptoms. In both varieties there is apt to be 
irritation and uneasiness about the rectum and anus, with itching, 
stinging, lancinating, twinging pain, also pain at stool with a 
desire to strain, dragging pains in the back, loins, perineum 
and thighs, headache and giddiness. If from any cause they 
become inflamed, they give rise to the most intense suffering, 
and if in defecating they protrude, the attempt to return them 
occasions the most excruciating agony. In the external form, 
the tumors can be readily felt. In the internal, they usually 
affect the general health, and in addition to the symptoms 
already enumerated, there is flatulence and indigestion. The 
tumors are often protruded and painful at stool, and there is a 
sensation as of a foreign body in the rectum, with warmth and 
pricking, and frequent attacks of profuse hemorrhage. These 
symptoms may not all be present in one person, and indeed some- 
times are somewhat obscure; when such is the case, an exam- 
ination by a competent physician will always determine the true 
character of the complaint at once. 
1233. Treatment. Notwithstanding the well estab- 
lished fact that piles are readily cured by the appropriate 
treatment, hundreds of thousands of people suffer untold PILES 
599 
tortures from them; and what is worse, they suffer from them 
because of the popular impression that they cannot be cured. 
All cases are not, however, amenable to the same form of treat- 
ment, for various unhealthy conditions of the system are often 
concerned in their production and perpetuation, and must of ne- 
cessity be remedied by appropriate treatment, before a cure of 
the piles can be expected. It will therefore become apparent 
that the avoidance of causes is of paramount importance. Some 
of these causes are external, and wholly under the control of the 
patient, while others depend upon diseases that are curable; it 
frequently happens, that while these other diseases are being 
remedied, the piles disappear without any special attention. 
1234. Diseases of the liver may be reckoned among the chief 
causes of piles, in consequence of the obstruction which they 
offer to the free return of blood from the hemorrhoidal veins 
into the general circulation through the vena cava 53, Fig. 
32, and 66, Fig. 41). By this obstruction, distention of the 
anal extremities of those veins is produced, and if long continued, 
their walls lose their elasticity, become diseased, and permanent 
pile tumors result. For the treatment of this complication, the 
reader is referred to the chapter on diseases of the liver (*[ 1128), 
and particularly to that portion relating to chronic congestion 
and inflammation. 
1235. Diseases of the urinary apparatus, as stricture of the 
urethra, enlargement of the prostate gland, and stone in the 
bladder, dysentery, diarrhoea, and constipation,—all cause piles, 
by the irritation, and determination of blood, which they induce; 
these difficulties must be removed by appropriate treatment, and 
the reader is referred to the management recommended under 
their respective chapters. 
123G. Some years since, I ascertained that I was using in my 
practice remedies which, in addition to their other virtues, pos- 
sessed a direct curative influence upon the vessels concerned in 
the formation of piles. These agents enter into the composition 
of my Golden Medical Discovery, which consequently will be 
found exceedingly efficacious in the treatment of this disease. 
This remedy, therefore, in removing the disease upon which the 
piles depend, and in exciting a direct curative control over the 
piles themselves, exerts a double influence. 600 
COMMON SENSE MEDICAL ADVISER. 
1237. Sometimes, in consequence of structural changes in the 
rectum, local applications are necessary to aid the constitutional 
treatment. These applications, however, must be determined by 
the nature of the case, though usually I have found my Pile 
Ointment all the local application necessary to effect a cure. 
1238. While carrying out the above treatment, it is scarcely 
necessary to remind the reader that those hygienic directions so 
essential to health, must not be overlooked. The diet must be 
non-stimulating, and calculated to aid in overcoming constipation, 
if it exists; alcoholic stimulants must not be indulged in, and 
plenty of outdoor exercise, with the frequent use of the bath, 
must be inculcated. 
1239. Occasionally cases are met with, which, from the enor- 
mous distention of the blood-vessels concerned, and the disease 
of their walls, constitutional treatment alone is unable to cure. 
But, fortunately, such cases are the exception instead of the rule, 
and even these may be readily and radically cured by a surgical 
operation, which consists in removing the tumors. If they are 
external, they are clipped off with a pair of sharp scissors, and 
the wounds touched with a styptic application, to prevent hem- 
orrhage. If internal, the tumors are brought down, and either 
tied tightly at the base, so as to strangulate them, when they are 
returned inside the anus and allowed to slough off, as they will 
in a very few days, leaving the bowel smooth and healthy; or, 
they are tightly clamped with instruments designed for that 
purpose, removed with the scissors or knife, the wounds touched 
with nitric acid, to prevent hemorrhage, the clamps being then 
removed and the bowel returned. Mr. T. Homes, Surgeon and 
Lecturer on surgery at St. George’s Hospital, London, says he 
has performed the latter operation in upwards of two hundred 
cases, and can with truth state, that if it be properly done, there 
is hardly an element of danger in it. Although not having 
operated in as large a number of cases as Surgeon Homes, yet 
my operations have been numerous, and have been uniformly 
followed by the most satisfactory results. I have no hesitation 
in recommending such an operation in all cases of piles where 
medical treatment proves unsuccessful; if performed by a skillful 
surgeon it is but slightly painful, and is generally followed by 
permanent relief. PILES 
601 
1240. Case I. J. R. S., aged 35, by occupation a book- 
keeper, consulted me by letter, in June, 1873, stating that he 
had suffered severely for several years past from piles, with fre- 
quent hemorrhages. He was troubled with dyspepsia, colic, 
constipation, headache, and with the usual sensations in the rectum 
which accompany piles. I directed outdoor exercise, and atten- 
tion to diet. Internally, I gave him my Golden Medical Dis- 
covery, with Pile Ointment to be used locally. Also prescribed 
special medicine for the dyspeptic complication. Under this 
treatment, he soon recovered his health, and has remained well 
ever since. 
CASES TREATED. 
1241. Case II. Mr. D., a laborer, aged 50, married, con- 
sulted me by letter, in September, 1873. He had for several 
years been subject to attacks of piles, his bowels were irregular, 
diarrhoea alternating with constipation. He was in the habit of 
drinking more or less beer, and occasionally something stronger. 
He experienced a sense of weight and fullness in the region of 
his stomach, his tongue was coated and he suffered from dizzi- 
ness, or, as he termed it, biliousness. He had been in the habit 
of resorting to the use of some of the popular cathartic medicines 
of the day, but they only gave him temporary relief. I attrib- 
uted the piles to two circumstances; the deranged condition 
of the liver with consequent obstruction to the flow of blood 
from the hemorrhoidal veins, and to the employment of the 
cathartics which he used. I gave him directions to stop the use 
of all stimulants, and not to take any more cathartics, even if 
he should get bilious; told him to bathe freely, regulate his diet, 
and take my Golden Medical Discovery four times a day. He 
followed my directions, and in two months all his troubles had 
disappeared, and have not since returned. 
1242. Case III. George M., aged 30, consulted me by 
letter, in August, 1873, for piles, which frequently bled. lie 
was of an encephalic, sanguine temperament, his general health 
impaired, had palpitation of the heart, bowels usually regular, 
had a good deal of headache, was of sedentary habits. Urine 
sometimes cloudy, and occasioned pain in passing it. Used 
tobacco and drank beer. His disclosures revealed the fact that 602 
COMMON SENSE MEDICAL ADVISEE. 
sexual excitement was injuring him. I gave him appropriate 
advice regarding the latter, told him to stop his beer entirely, 
moderate the use of tobacco, eat unstimulating food, and 
apply the warm-bath at night, and the cold hand-bath in the 
morning, to the lower part of his back, loins, and bowels. He 
was also given such treatment as the complicated condition 
demanded, with my Pile Ointment applied to the tumors. He 
continued under treatment for about three months, when he con- 
sidered himself well, and stopped medicine; he continues to 
follow however, my hygienic advice, and not long since wrote, 
expressing his thanks, and saying that he remained perfectly well. 
1243. Cas© IV. J. O., aged 36, married, consulted me 
personally. His case was a bad one. He had dyspepsia, palpita- 
tion, headache, dizziness, tenderness over stomach, and frequent 
attacks of colic. His general health was very badly deranged, 
and he was despondent, gloomy and morose. He remained 
under my care for a month, during which time the most rigid 
hygiene was enforced, with such medical treatment as the com- 
plicated nature of his case called for, and with the most gratifying 
results. At the end of the month, he left for home, taking with 
him a quantity of Golden Medical Discovery, which he continued 
to use, and in three months wrote me that he was enjoying 
better health than he had in many years before, with not a 
single symptom of his old complaints, and what is more gratify- 
ing, I learned two years later that he still continued well. 
1244. Case "V. Erastus —, aged 35, single, came to the 
World’s Dispensai-y, in February, 1873. For eight years he had 
suffered more or less from piles, and for a considerable time they 
troubled him continually. The hemorrhages were so frequent and 
copious as to tell fearfully upon his health, and he was pale and 
haggard. He had been under the care of several medical men, but 
with no relief. He was despondent, morose, and had thoughts of 
committing suicide. Taking into consideration the very large size 
of the tumors, his condition, the continual loss of blood, and the 
failures of others to cure him, I advised an operation for the 
radical cure of the disease. The operation was performed, appro- 
priate constitutional treatment enjoined, and he remained with 
me two weeks, when he had so completely recovered as to return 
home. The operation was permanently successful, for he writes FALLING OF THE LOWER BOWEL. 
603 
eight months after, “ You would not recognize in me, a hale, 
hearty and robust man, weighing 165 pounds, the pale, wan, 
emaciated, despondent creature that came to your hospital in 
February last. I am a well man, and I can’t be thankful enough. 
I shall recommend many invalids to you.” 
1245. Case "VI. Mr. B., a shoemaker, aged 29, consulted 
me in 1867, and was suffering terribly from internal bleeding 
piles. He was much emaciated, had poor appetite, and was very 
nervous and despondent. On examination, the tumors were 
found to be very large, and at his request, as he was so nervous 
and the tumors very sensitive, chloroform was administered and 
an operation promptly performed. Eight very large tumors 
were removed. The wounds promptly healed, leaving the bowel 
perfectly healthy, and in two weeks he was laboring at his usual 
vocation, and continued well when last heard from. 
FALLING OF THE LOWER BOWEL. (Prolapsus Asti.) 
1246. This affection, which is divided into two varieties, 
partial and complete, consists of a descent and protrusion of the 
mucous membrane of the rectum, and in many cases, of the sub- 
mucous and muscular coats also. This protrusion beyond the 
margin of the anus, which. varies greatly in degree, as may be 
readily seen by the accompanying illustrations, generally occurs 
when at stool, and when not severe is usually easily replaced. If 
for any reason it cannot be returned, violent inflammation, great 
constitutional disturbance,with sloughing of the protruded bowel 
occurs, by which means a cure is sometimes brought about, 
though it occasionally ends in death. It may occur in either sex 
and at any period of life, but is much more frequently met with 
in childhood or old age, than in adult life. When the protrusion 
is not very extensive, it is frequently mistaken for piles. 
1247. Causes. Various causes are capable of producing 
prolapse of the bowel, among which are chronic diarrhoea, dys- 
entery, habitual constipation, or constipation alternating with 
diarrhoea, piles, ulcers, pin-worms, drastic cathartics, falling 
of the womb, stricture of the urethra, enlargement of the prostate, 
stone in the bladder, in fact anything that obstructs the passage 
of the faces or urine, and thus causes straining in defecation or 604 
COMMON SENSE MEDICAL ADVISER. 
urinating. The predisposing causes are: a want of tone, feeble 
contractility, loss of muscular power—relaxation of the sphincters 
of the anus; relaxation of the intestines, or muscular debility, 
no matter how produced. 
1248. Symptoms. A dragging sensation in the rectum, 
extending to the back and loins; a sense of fullness, etc., similar 
to that experienced in piles, with protrusion of the bowel while 
at stool. In the incomplete variety, illustrated 
by Fig. 154, the protrusion of the falling bowel 
usually shows itself in the form of a fold of 
mucous membrane on either side of the anus; 
forming a soft, spongy tumor, of a florid color, 
and devoid of tenderness; there may, however, 
be several of these folds or tumors presented 
at the same time; and if they remain long 
protruded they become congested, assume 
a dark red appearance, and are the seat of more or less 
pain. 
In the complete variety, illustrated by Fig. 155, the protrusion 
is greater, sometimes extending several inches beyond the anus, 
and forming a tumor as 
large as the fist, or even 
larger, of a cylindrical 
shape, truncated, of a 
florid color,with a wrink- 
led surface and tender to 
the touch. It sometimes 
comes down while pass- 
ing water, as well as when 
at stool. By being fre- 
quently prolapsed it un- 
dergoes changes of struc- 
ture, becoming congested and inflamed, and finally hardened and 
thickened. Hemorrhage sometimes occurs. 
Fig. 15 If.. 
Incomplete prolapse of 
the Rectum. 
Fig. 155. 
Complete prolapse of the Rectum. 
1249. Treatment. In treating this affection an avoid- 
ance of all exciting causes must he insisted upon, or a cure can- 
not he expected. The howels must he regulated, and the general 
health improved; while every possible precaution must be taken 
on all occasions, to prevent the parts from protruding, or the FALLING OF THE LOWER BOWEL. 
605 
sphincters (muscles surrounding the anus) cannot recover their 
normal power. The invalid should never strain at stool, and in- 
deed he will be more successful in his efforts to avoid the protru- 
sion, if during the act of defecation he assumes some different 
posture from that usually taken, and the recumbent position is to 
be preferred. Cold water, injected into the rectum and retained 
for a minute or two, immediately prior to defecation, is worthy 
a trial, and after the evacuation the protruded bowel should be 
carefully sponged with cold water, and before being returned 
lubricated with some oily substance, as a substitute for the natu- 
ral mucus which has been removed. Careful attention to the 
condition of the stomach, liver and bowels is always necessary, as 
the causes discussed under piles 1231) are sufficient to produce 
and perpetuate this disease, and for the reasons there given, my 
Golden Medical Discovery is of the very greatest value, relieving 
the rectal congestion, and by its specific and tonic effect giving 
tone to the relaxed sphincters. Its action may be materially 
aided by the use of some of the vegetable tonics (*jf 607) men- 
tioned in this volume. This internal treatment should be aided 
by the injection of astringent infusions into the rectum twice a 
day; for this purpose some of the astringents 514) men- 
tioned will be found exceedingly valuable. In addition to this 
treatment, bathing the lower portion of the bowels, back and 
loins with cold water, several times a day, will be found a valu- 
able adjunct; when the whole treatment above recommended 
is carefully carried out, the very best results may be anticipated. 
1250. When, however, from any cause, medical treatment 
fails to cure, in consequence of the structural changes these 
parts have undergone, surgical means are available, and several 
operations have been devised to suit the emergencies; when per- 
formed by a competent surgeon, they are productive of the most 
gratifying results. The operations performed at the World’s 
Dispensary, variously modified to suit the nature of the case and 
combined with strict hygienic and constitutional treatment, have 
always proved successful. 
1251. Case I. Wm, P., aged 32, consulted me by letter 
in 1873, regarding an affection of the anus, which from his 
CASES TREATED. COMMON SENSE MEDICAL ADVISER. 
description, I concluded to be prolapsus. The boAvel protruded 
an inch or more at every evacuation, and Avas usually painful 
and tender, sometimes bleeding. He stated that his general 
health was ordinarily good, though he was slightly salloAV, bowels 
somewhat costive, and he was troubled a little Avith dyspepsia. I 
directed him to follow the above hygienic rules, take four 
doses of my Golden Medical Discovery every day, Avith a single 
Pellet after dinner, and inject into the rectum tAvice a day a 
strong infusion of witch-hazel 518). This treatment he 
followed some time, and though at first he made but little im- 
provement, yet perseverance rewarded him with a complete cure. 
1252. CSISG II. Joseph —, aged 57, a merchant, wrote 
me early in 1874, that he was suffering from prolapsus of the 
rectum, which had resisted all forms of treatment for several 
years; that the protruded bowel Avas thickened, hardened, and 
when down, formed a tumor larger than his fist. He also said if I 
thought best he would come to the World’s Dispensary for treat- 
ment. I advised him to come, as an operation might be neces- 
sary. On his arrival, I found his general health greatly impaired 
by long suffering. He Avas thin, pale, dyspeptic and weak. As 
he was prepared to remain for a time, I at once put him under 
thorough hygienic and constitutional treatment, to relieA7e his 
obstructed circulation and remove the congestion of the loiver 
boAvel. In three weeks he had made decided improvement, and 
I performed the necessary surgical operation for a radical cure. 
The constitutional treatment was kept up until his general health 
was fully restored, and in tAvo months from the time he arrived, 
he returned home perfectly well, a Avonder to all Avho knew 
him. 
ANAL FISTULA. (Fistula in Ano.) 
1253. This form of rectal disease is of frequent occurrence, 
being met with among all classes, and at all periods of existence, 
though most prevalent in adult life. It is most common among 
males, though not confined to this sex. It consists of an abnor- 
mal or artificial passage from the rectum to the surface of the 
skin, the walls of which are thickened and indurated, and give 
rise to an offensive discharge. The direction of this unnatural 
passage varies greatly, as well as its points of communication AVAL FISTULA. 
with the rectum, or skin. The rectal apperture, however, is 
seldom more than an inch and a half from the verge of the anus, 
oftener much less, while the external outlet varies from a frac- 
tion of an inch to several inches, and in one recorded instance, 
the fistula made its exit near the knee. There are sometimes 
several orifices communicating with the rectum or skin. In some 
instances the external is so minute as to be scarcely per- 
ceptible, except by the moisture of the part in the vicinity of 
the opening. Surgeons usually divide this disease into two varie- 
ties, the complete, and incomplete, or “blind.” In the complete 
form, the fistula communicates with both the rectum and the 
external surface of the body. In the incomplete, which is divided 
into “ internal ” and “external” blind fistula, the passage has 
but one opening; the “internal” having an opening into the 
rectum, but not through the skin; and the “external” having an 
opening through the skin, but not into the rectum. This affec- 
tion is frequently associated with a broken-down condition of 
the system, and occasions intense annoyance to the patient. 
1254. Causes. Constitutional predisposition, constipation, 
piles, or the presence of foreign bodies in the rectum, causing an 
abscess or ulcer. Some authors have contended that fistula 
always originates from an ulcer in the rectum, which gradually 
makes its way through cellular tissue to the surface. Others 
contend that the cause of this disease consists in an abscess, 
which burrows in the tissues and makes its exit into the 
rectum, or through the skiu, or both. No doubt both of these 
views are correct, and it can readily be seen that when an inter- 
nal opening is once established, the faeces which enter into it must 
sooner or later work their way to the surface, burrowing through 
those parts that offer the least resistance, until a place of exit is 
reached. 
1255. This is often a matter of considerable 
interest, and it requires not a little skill, to conduct the manipula- 
tions necessary to the satisfaction of both the patient and physi- 
cian. The disease may be suspected, if there has been an abscess 
in the parts involved, or if the patient has been subject to pain 
in the rectum, and the parts are tender, tumid, or indurated. 
When the fistula opens externally, the linen will be moistened 
and soiled with pus, or a bloody fluid, and when the tract is 608 
COMMON SENSE MEDICAL ADVISER. 
large, the fasces may pass through it. A careful exploration with 
a probe, passed into the external opening while the finger is in 
the rectum, generally reveals the direction of the tract; but, 
sometimes, in consequence of the tortuous course of the canal, 
the probe cannot be made to follow it. When the fistula is 
incomplete, and opens internally, the probe is passed into the 
rectum and directed outwards through the orifice, when it may 
be felt externally. In such cases a tumor caused by the contents 
of the fistula, may generally be seen presenting near the anus, 
and the pain will be considerably increased during defecation, 
by the fieces passing into it and disturbing its walls. The exam- 
ination should be made with the greatest possible care, for it is 
attended Avitli more or less pain. 
1256. Treatment. When constitutional derangement 
exists, it must be rectified, or any treatment Avill be liable 
to result in failure. The comfort of the patient may be greatly 
promoted by attention to the bowels, keeping their contents in 
a soluble condition, and the liver active, so as to prevent conges- 
tion of the rectum and adjacent structures. This can best be 
done by careful attention to hygiene, and the internal employ- 
ment of my Golden Medical Discovery and Pellets, in sufficient 
quantities to produce the above-named effects. 
A radical cure, however, cannot be accomplished except by 
surgical means, for which we have the knife, ligature, caustic, 
stimulating injections, etc., which may be varied to suit the 
emergency, and should never be employed, except by a com- 
petent surgeon. Constitutional conditions will materially influ- 
ence the cure, no matter what procedure is adopted; the greater 
the constitutional derangement and the poorer the general 
health, the longer will the cure be delayed. If there is any con- 
stitutional derangement whatever, it is a good plan to put the 
patient under appropriate medical treatment, according to the 
nature of the case, for a month or two before the radical cure is 
undertaken. The great secret of my success in treating this 
disease depends upon carrying out this plan. 
1257. The use of the knife is becoming obsolete, and has to 
a great extent given way to other measures which are equally 
successful. Indeed, other means will succeed in cases where 
the knife fails or is for any reason inapplicable. One great ANAL FISTULA. 
609 
objection to the knife is, not only the dread which patients 
entertain of it, but the great liability of its use resulting in pa- 
ralysis of the sphincters of the anus, in consequence of which the 
patient loses control over the bowels; and another is that it 
sometimes fails entirely to result in cure. By the means which 
I employ these objections are entirely overcome, and while the 
general system is being renovated, the fistula is healed without 
any trouble following it. The existence of fistula is much,more 
frequent than has been generally supposed, and is quite apt to be 
associated with pulmonary diseases. Heretofore it has been 
supposed that to heal the fistula during the progress of the 
other affection would result in fatal consequences, and the 
patient has been left to suffer and die, under the combined 
influence of the two diseases. Observation, based upon an 
extensive experience in the management of such diseases, has 
proven that argument fallacious in every respect, and I would 
urge all persons afflicted with fistula to have it cured, no mat- 
ter wdiat complications there may be. The fact underlying 
this fallacious theory is, that when grave constitutional troubles 
have co-existed, the use of the knife has resulted in failure, and 
the fistula has refused to heal. 
1258. The constitutional treatment for the purpose of build- 
ing up the system and freeing it of impurities, may readily be 
carried out at the patient’s home by the means already recom- 
mended; and in the majority of cases, should be done before the 
local treatment is commenced. The cure of the fistula itself, 
however, can only be successfully performed under the manage- 
ment of a judicious surgeon, and the difficulty in the way of 
cure is usually reserved for the specialist to overcome; the 
length of time required must necessarily depend upon the con- 
dition of the general health, the nature of existing complications 
and the character and extent of the fistula itself. 
1259. Having had ample facilities for observing the relative 
merits of the various methods of treating this complaint, in 
hundi’eds of cases, in my own practice and that of others, I feel 
justified in saying that the general plan which I have adopted 
has been attended with the most perfect success. The local 
treatment which I employ depends upon the nature of the 
fistula; in some instances the ligature is best, in others caustics 610 
COMMON SENSE MEDICAD ADVISER. 
and again injections, etc., while others require a combination of 
two or more, or a modification of them. 
1260. Case I. William C., aged 22, single, consulted me 
in 1870, for an affection of the rectum. Examination revealed 
the presence of a double fistula, also that he was laboring under 
constitutional syphilis. His general health was very poor at the 
time. I at once placed him under medical treatment to build up 
the system and purify it, and adopted such palliative means as 
would give him relief until such time as the surgical treatment 
could be safely undertaken. This was continued for some three 
months, when he had so much improved that the cure of the 
fistula by a combination of ligature and caustic was begun. In 
one month from this time he returned to his home, in Indiana, 
perfectly well. He continued the constitutional treatment for 
some time on account of his original difficulty. The result was 
a cure of both affections, and when last heard from he had 
experienced no return of the trouble. 
CASES TREATED. 
1261. Case II. Henry R., aged 35, consulted me in 1871, 
for “ fistula in ano.” He had suffered very much for several years, 
and his general health was greatly impaired. Several surgeons 
had refused to operate on him, in consequence of a hemorrhagic 
diathesis under which he labored. So great was this condition, 
that the extraction of a tooth nearly resulted in loss of life from 
hemorrhage, and the slightest scratch or cut generally gave rise 
to profuse bleeding. The surgeons whom he had consulted con- 
sidered that he would bleed to death if an operation was per- 
formed. Under these circumstances he consulted me, and I 
determined to cure him, though telling him that his cure would 
take time. I at once put him on treatment to overcome his con- 
stitutional dyscrasia, and in three months began the use of the 
ligature in a peculiar manner. In six months from the com- 
mencement of treatment he returned home greatly improved in 
health; indeed he said he was well. The fistula healed perfectly, 
and during the whole time he had not lost a single tablespoonful 
of blood. 
1262. Case HI. Edson E.,aged 40, consulted me in 1872, 
for the relief of fistula, complicated with what his physician FISSURE OF THE AXES. 
611 
called consumption, but which proved to be chronic bronchitis. 
I at once began such hygienic and constitutional management as 
his case demanded, and treated the fistula to injections of a stimu- 
lant and alterative character; in four months he was entirely 
relieved of the bronchitis and fistula, though I advised him to 
continue the hygienic treatment, with the Discovery, for some 
time longer. 
1263. Case IV. Lewis P., aged 44, consulted me in 1873, 
for a fistula, which had been caused by an abscess produced by a 
local injury. His constitutional condition was good. I pre- 
scribed such dietetic and hygienic treatment, with small doses of 
Discovery, as was necessary to regulate the bowels and favor the 
healing process. I employed the ligature, and in twenty days he 
left for home, the fistula having been perfectly cured. 
FISSURE OF THE ANUS. (Rhagades Axi.) 
1264. This, as its name implies, is an ulcer or fissure, or in 
other words, a “ crack ” of the mucous membrane of the rectum, 
and, though apparently insignificant in itself, is productive of 
the most intense suffering, and is extremely difficult to heal. It 
is seated just above the verge of the anus, and extends upward 
through the mucous membrane, in the shape of a gutter or 
groove, from half to one inch, and sometimes even farther. It 
is generally very irritable and sensitive to the touch, though its 
edges often become thickened, hardened and turned outwards. 
Sometimes it is so small as to be scarcely observable, though 
generally it is larger, and discharges a thin, mattery, bloody 
fluid. Frequently it is associated with a depraved or enfeebled 
condition of the general health, and by the patient is often 
mistaken for piles. 
1265. Causes. It often comes on without any assignable 
cause, but in a majority of cases, it is probably due to such 
modifications of the constitutional integrity as produce ulcera- 
tions elsewhere, as venereal, scorbutic or tubercular affections. 
It may, however, be caused by disorders of the stomach or 
bowels, piles, straining, laceration of the rectum, or by the pas- 
sage of hardened faeces. 
1266. Symptoms. The characteristic symptom of this 
affection is the horrible pain which the patient suffers, especially 612 
COMMON SENSE MEDICAL ADVISER. 
after defecation, and which is generally attended with spasmodic 
contraction of the sphincters of the anus, violent bearing down 
and straining, and soreness in the perineum and thighs. This is 
always aggravated by horseback exercise, walking, sexual inter- 
course and sitting on a hard seat. As the affection progresses, the 
bladder becomes irritable, intolerant of its contents, and there is 
a frequent desire to urinate, with pain and bearing down, weight 
and a dragging sensation in the perineum, the general health 
fails, the countenance becomes sallow and haggard, the appetite 
and strength decrease, and every thing denotes terrible suffering. 
The cause of these symptoms is easily determined by an ocular 
examination, during which the patient is directed to force the 
parts down as far as possible, when the lower margin of the 
fissure is brought into view. 
1267. Treatment. Various methods of treatment have 
been devised for the cure of this affection. It is very rarely, if 
ever, cured by constitutional treatment alone, though any con- 
stitutional derangement must be rectified, by such means as the 
nature of the complication demands. The contents of the bowels 
should be kept in a soluble condition, and the general health 
improved by every possible means. For these purposes, I would 
advise the use of my Golden Medical Discovery and Pellets, in 
appropriate doses, together with thorough hygiene and absolute 
cleanliness. The comfort of the patient will be promoted, and 
the cure hastened, by sponging the anus thoroughly clean with 
warm water, after each evacuation of the bowels, and before 
making any local application. 
The local treatment consists in the employment of such meas- 
ures as properly come within the domain of surgery, and for- 
merly consisted in the division of the sphincters of the anus and 
paring the edges of the fissure. Such a proceeding is at present 
seldom resorted to. The use of the knife is rarely necessary, 
and is gradually giving way to other means. The application 
of caustics is supplanting more extreme measures, and with 
equally good, if not better success. Their employment should 
always be made under the direction of a judicious and skillful 
physician, or a return of the difficulty will be apt to occur. The 
fact that it arises from constitutional causes in nearly every 
instance, should not be overlooked in the attempt to cure it, but CONGESTION OP THE BRAIN. 
613 
should always be met by such treatment as is laid down under 
the diseases which complicate it. 
1268. The application of caustics, even, is unnecessary and 
unjustifiable in many cases; the use of healing preparations of 
a stimulating character, after the cause is obviated, is often 
sufficient to effect a cure. The spasmodic contraction of the 
sphincters, and irritable condition of the bladder, must be over- 
come, or all treatment will prove futile. For this purpose agents 
that act specifically on those parts are required. In the absence 
of such agents, the judicious employment of anodynes locally, 
is advisable, and often productive of gratifying results. When 
these milder measures fail in effecting a cure, then, and not till 
then, should the application of caustics, or a surgical operation, 
be resorted to. 
CONGESTION OF THE BRAIN. 
1209. The great functional activity of the brain is indicated 
by the large proportion of the blood required for its health- 
ful exercise. An unnatural determination of blood to that 
organ results in a morbid condition, termed active congestion of 
the brain. 
1270. Causes. This disease is caused by protracted men- 
tal exertion, intense emotion, sunstroke, etc., and may terminate 
in apoplexy or coma. In the delirium caused by the excessive 
use of alcoholic stimulants, active congestion is a prominent 
pathological condition. 
1271. Symptoms. Active congestion of the brain is in- 
dicated by intense pain and fullness in the head. The eyes are 
suffused and extremely sensitive to light. The head is very hot, 
the face flushed, the mind confused and the pulsations of the 
carotid and temporal arteries are slow and strong. The 
violence of the symptoms will depend upon the degree of 
congestion. 
1272. Treatment. Moderate congestion of the brain is 
not dangerous and may be removed by administering an active 
purgative. Severe active congestion is liable to produce apo- 
plexy and sudden death. The application of ice to the head, a 
hot foot-bath and a thorough purgative are often the only 
remedial measures required, but in extreme cases the free use of 614 
COMMON SENSE MEDICAL ADVISEE. 
veratrum must be resorted to and will generally afford speedy 
relief. 
1273. Passive COBlgestioil of the brain is a patho- 
logical element entering into various affections, but cannot be 
considered as a distinct disease. 
1274. The Symptoms are drowsiness, mental inactivity, 
and in children, convulsions. 
1275. Causes. Any mechanical impediment which pre- 
vents the return of the blood from the brain will induce passive 
congestion. It also occurs in certain diseases of the heart 
where there is diminished arterial circulation. 
1276. Treatment. If the morbid condition is produced 
by any mechanical obstruction, as tumor of the neck or cardiac 
lesion, it can only be remedied by the removal of the impedi- 
ment. If caused by a weak circulation, stimulating tonics and 
nutritious diet are the proper remedies. 
INFLAMMATION OF THE BRAIN AND ITS 
MEMBRANES. 
1277. The membranes (If 115), as well as the substance of the 
brain, are liable to chronic and acute inflammation and may be 
partially or generally involved. When the membranes are the seat 
of inflammation, it is called Meningitis. Usually when the brain 
proper is the seat it also involves more or less the arachnoid, (spi- 
der’s web) the dura mater (hard mother) and pia mater (soft 
mother) membranes, in the inflammation. It is unnecessary here 
to award a separate consideration to each membrane, as though 
its inflammation were a distinct affection. 
1278. Symptoms. The symptoms are pain in the head, 
restlessness, despondency and sometimes delirium. Sooner or 
later the patient experiences a chill, is dizzy, the eyes look red, 
become sensitive to light, the hearing is acute, the face is flushed 
and there is wakefulness and also confusion of ideas. The pul- 
sations of the arteries leading from the neck to the head can be 
distinctly seen, the pulse is quick, the skin hot and there is intense 
thirst. Children turn their heads from side to side, moan, some- 
times scream in their sleep as if frightened, and the thumb is 
drawn down into the palm of the hand when attacked by con- 
vulsions. If the disease be not arrested, whether the patient is SPOTTED FEVER. 
615 
young or old, he gradually sinks into a deep stupor and it is with 
difficulty that he can be aroused. The sensibilities to light and 
sound are blunted, the pulse becomes slow, the skin cold and 
moist and the vital powers gradually succumb to the disease. 
1279. Causes. The causes producing inflammation of the 
brain and its membranes are various. Injuries from blows, con- 
tusions, falls, sudden colds, or excess of mental labor. Some 
persons are very excitable, highly emotional, or otherwise are 
predisposed to insanity. It may be produced by intemperance, 
loss of sleep, irregular habits, excessive sexual indulgence or 
masturbation. It occasionally results from translation of acute 
or chronic affections of the skin to the brain. 
1280. Treatment. The treatment must be modified 
according to the condition of the patient. I would not advise 
my non-professional readers to attempt the treatment of these 
formidable and dangerous diseases, but would suggest the em- 
ployment of a competent physician. 
SPOTTED FEVER. (Cerebro-Spinal Meningitis.) 
1281. There are two forms of this disease. One is charac- 
terized by all the symptoms of inflammation—ringing in the 
ears, pain in the head and back, restlessness and delirium, but 
sensation and motion are not impaired. In the second form, the 
nerves of sensation and motion are paralyzed and consciousness 
is lost. This disease sometimes prevails as an epidemic in some 
localities, and is most apt to attack young persons. 
1282. Symptoms. The attack is usually sudden, like the 
taking of a severe cold, and is accompanied by pain in the head, 
fever, acceleration of the pulse, which becomes rapid and full. 
Purple spots often appear on the surface, there is thirst, the 
muscles become rigid, the head is drawn backward and the pain 
in it becomes very violent. The patient grows stupid and deaf, 
is not easily aroused, and unless the disease is arrested by medi- 
cal treatment, coma and death supervene. The patient at the 
commencement of the attack sometimes complains of feeling 
sore all over, he cannot bear the slightest touch and dislikes to 
change his position in bed. 
1283. Cau§e. It is not well understood what it is that 
predisposes the brain and spinal marrow to this inflammation. 616 
COMMON SENSE MEDICAL ADVISER. 
Many attribute it, however, to malaria. The exciting causes are 
sudden variations of the temperature, taking cold, repression of 
the secretions, etc. 
1284. Treatment. The indication of treatment is to 
bring the blood to the surface and induce free and copious per- 
spiration. I would recommend wrapping around the patient’s 
naked body a woolen blanket, wrung out of hot water, and 
placing outside of the blanket ears of corn taken out of boiling 
water. Then cover with comfortables, so as to retain the heat 
and steam, and thus sweat the patient profusely. 
Some physicians commence the treatment by administering an 
active and thorough cathartic, and then bathe the patient in hot 
lye, medicated with salt, pepper and mustard. This treatment 
should be followed by rubbing the surface with tincture of 
pepper or other stimulating rubefacients. 
1285. As soon as the patient is steamed by the corn, give 
him full doses of my Extract of Smart-Weed to keep up the 
perspiration. If the pulse is yet active, give from one to three 
drops of fluid exti-act of veratrum 597) every hour, until it is 
sufficiently reduced. If the pain in the head be severe, dry 
cupping over the neck and spine may relieve it. If there is 
retention of urine, constipation, involuntary stools, convulsions 
or palsy, the attack is very severe and very liable to prove 
fatal. A disease of so dangerous a character should be treated 
by the family physician. 
APOPLEXY. 
1286. Apoplexy may be defined as a sudden cessation of all 
the vital functions, except those of the lungs and heart. It is 
caused by a sudden effusion of blood or serum upon the brain. 
In the former case, the shock is due to a sudden rupture of one 
or more of the cerebral arteries, the membranes of which have 
become tender or brittle by age or calcareous deposits. This 
form of apoplexy has also received the name of cerebral hem- 
orrhage. Serous apoplexy is due to a collection or effusion of 
the serum beneath the arachnoid membrane. 
There are three modifications of this disease, as regards its 
severity, each characterized by peculiar symptoms. The first 
form which I shall mention is always attended with fatal results. APOPLEXY. 
617 
Complete coma usually supervenes in a few moments after the 
attack; it is seldom preceded by incipient symptoms, but its 
victims are stricken down without a warning. 
1287. The second form which I shall notice, frequently 
results in partial recovery. A portion of the body is paralyzed, 
and the intellectual powers seriously impaired. 
The third modification consists of those sudden and transient 
attacks of apoplexy which are produced by an undue deter- 
mination of blood to the brain, or a retention of venous blood in 
that organ. The attack is usually of short duration, but sudden 
death may ensue. 
1288. SyiUg&tOEBBM. In the first form of apoplexy which 
we have considered, the prominent symptoms are sudden and 
violent pain in the head, faintness, nausea and sometimes vomiting. 
The face becomes ghastly pale, and the pulse is weak and irregu- 
lar, but these symptoms gradually subside. The pulse becomes 
stronger, the mind clear, and the patient appears to be recovering. 
Presently, his face becomes flushed, even livid, he rapidly sinks 
into a profound stupor or coma, and death quickly supervenes. 
The second form is characterized by a sudden paralysis of 
some portion of the body—usually one side—when it is termed 
hemiplegia. The attack is accompanied by a total or partial loss 
of consciousness. The power of sensation, and in some instances 
of motion, is gradually regained, and many months, or even years 
may intervene before the final shock which produces the apoplectic 
coma. In this form the quantity of effused blood upon the brain 
is very small. 
The third variety is a sequence of cerebral congestion, and is 
attended by a cold, clammy sweat and sudden coma. 
The premonitory symptoms of apoplexy are loss of memory, 
frequent headache, drowsiness, and ringing in the ears. 
1289. Causes. These are various. (1st.) There may exist 
a constitutional predisposition to apoplexy. I do not mean a 
peculiar conformation of body, but refer to its hereditary trans- 
mittance. (2d.) Age also predisposes the system to this disease. 
All the membranes become less elastic and hence more liable to 
rupture. (3d.) Excessive mental exertion, gormandizing, drunk- 
enness and debauchery, are all prominent causes of apoplexy. 
1290. Treatment. Formerly blood-letting was always 618 
COMMON SENSE MEDICAL ADVISEE. 
resorted to in apoplexy but modern research and observation 
have proved that this disease is not due to an excess of blood in 
the system, but to an unequal circulation. To equalize the circu- 
lation is, therefore, a proper indication to be fulfilled. When 
the skin is clammy and cold, stimulants must be applied. The 
patient should be placed in a well ventilated room, ice applied to 
the head, and hot foot-baths used, followed by friction upon the 
extremities. A brisk cathartic should be administered, and if for 
any reason swallowing is impossible, a powerful injection must 
be administered. With the most skillful and careful treatment, 
recovery cannot be insured, as the quantity of blood discharged 
by the ruptured vessel may be so large as by pressure to paralyze 
the nerves, and indirectly, all of the vital organs. No time should 
be lost in summoning a competent physician in a case fraught 
with so much danger. 
PARALYSIS. 
1291. Paralysis, otherwise known as palsy, may be defined as 
a sudden or gradual loss of sensibility and motion in some part 
of the body. There are three forms of paralysis, viz: (1.) Hemi- 
plegia■, or paralysis of one side of the body. The seat of this 
affection is the brain. (2.) Paraplegia, oi paralysis of the lower 
portion of the body, results from an injury to the spinal cord. (3.) 
Local paralysis, in which only one member, or portion of a mem- 
ber, is affected. It is often difficult to determine whether this 
form is central — originating in a morbid condition of the nerve- 
centres— or is caused by an injury to the distal extremities, as in 
cases of lead poisoning. 
Other varieties are also mentioned as facial paralysis, palsy of 
the muscles of the face; paralysis agitans, or shaking palsy; in- 
fantile and diphtheritic paralysis. 
Facial Paralysis, when accompanied by hemiplegia or palsy 
of one side, is the result of cerebral disease. But facial palsy 
often occurs during the most perfect health and produces no 
derangement whatever in the animal economy. Its sudden ap- 
pearance is characteristic of facial paralysis, and terror, grief, a 
current of cold air, or habitual exposure to a damp atmosphere, 
are often its exciting causes. It usually involves only the muscles 
of one-half of the face, but in rare instances affects both sides. PARALYSIS. 
619 
Iii a complete facial paralysis, all natural expression is lost, and 
the patient cannot articulate words so as to be understood, with- 
out making a great effort. 
Paralysis agitans is the name given to the irregular, purpose- 
less tremors of the muscles, due to various causes, as the use of 
mercury, or a deranged nutrition of the nerve-cells, etc. The 
force of habit is especially noticeable in the perpetuation of this 
disease, for “ the tremor, which at first, excited by some casual 
circumstance, might by appropriate means have been perma- 
nently stilled, when allowed to become habitual, exceeds our 
powers of control.” 
Infantile paralysis originates in various pathological condi- 
tions, and presents phases easily distinguishable from organic 
affections, by signs of inflammation in the spinal cord or brain. 
ZHptheritic paralysis in its earliest stages extends from the tips 
of the fingers and toes to the trunk. This fact is not proof that 
the morbid condition does not reside primarily in the nerve- 
centres, but careful observation has shown that there exists no 
morbid organic change of the nerve-cells in fatal cases of dip- 
therial paralysis. Concerning the cause of this affection, Dr. C. 
Hanfield Jones, remarks: “As numerous cases of even severe 
diphtheria recover without any paralysis, it follows either that 
some special modification of the original poison must be gener- 
ated in the system, or what is more probable, that a certain pecu- 
liar state of the nerve-centres is requisite to allow them to become 
paralyzed by the poison.” 
1292. Symptoms. Generally there are no premonitory 
indications of this disease, hut instances are recorded in which 
the attack was preceded by the peculiar symptoms of apoplexy, 
as giddiness, transient numbness, loss of memory, drowsiness, etc. 
Sometimes it is gradual, and indicated by the numbness of a fin- 
ger or toe, the paralysis soon spreading until a large portion of 
the body becomes affected. 
1293. Causes. Cold, dampness, miasms, protracted mus- 
cular exertion and straining, are all exciting causes of this disease. 
Certain minerals, as white-lead, and also injuries of the spine, 
wounds, and unnatural postures (especially those which require 
twisting of the jugular vein) induce paralysis. Spermatorrhoea 
frequently results in this malady. 620 
COMMON SENSE MEDICAL ADVISEE. 
1294. Treatment. The indications of treatment for 
these various forms of paralysis are to remove the causes, if 
these can be determined, and rouse the functions of the paralyzed 
parts. Measures should be adapted to remedy the morbid con- 
ditions upon which this affection depends. Unfortunately, in 
most instances, this disease depends on lesions which are irreme- 
diable, so that even at best, success is only partial. The main 
object to be fulfilled, by domestic management, is to keep the 
skin clean and healthy, promote the circulation of the blood, 
especially in the palsied limbs, and encourage healthy nutrition. 
These ends may be best attained by the daily use of stimulating 
baths, frictions upon the surface, gently rubbing with the warm 
hand, the use of electricity or magneto-electricity, and by taking 
as much regular exercise daily as the patient can comfortably 
endure, in order to favor the preservation of the appetite and 
strength. Careful attention should be paid to the condition of the 
bowels, that they daily be evacuated. Next ascertain if the kid- 
neys excrete the proper amount of urine. The circulation is some- 
times aided by the manipulation of the palsied part by a person 
who is of a differently tempered constitution. These manual 
movements upon the surface of the body will often excite mus- 
cular sensibility, similar to that awakened by a weak current of 
electro-magnetism. The internal remedies should be such as to 
regulate the general functions of the system, while special medi- 
cines should be employed to stimulate the nerves and excite 
muscular contraction in the paralyzed parts. Those usually em- 
ployed are the tincture of mullen seeds, strychnia, gelseminum, 
belladonna, quinine, rhus, ergot, etc.; and the use of these reme- 
dies must be directed by the skill and experience of those 
professionally qualified to administer them. 
1295. Epilepsy, also termed falling sickness, because its attack 
is so sudden that it oftentimes occurs without any premonition, 
is characterized by paroxysms which are denoted by loss of sensa- 
tion and by convulsive movements of the muscles. In some cases 
the attack is preceded by giddiness, stupor, and indisposition; 
the patient occasionally experiences a wave of cold commencing 
at the feet and proceeding to the head, and as soon as it reaches 
EPILEPSY. (Fits.) EPILEPSY. 
621 
the brain, he falls and remains insensible from five to twenty 
minutes. At the onset of the paroxysm, the patient sometimes 
utters a piercing shriek, as though he had taken one full inspira- 
tion in order to be able to give a loud warning of his attack, 
and when it occurs during the still hours of night, the terrific 
cry is truly appalling. 
1296. Symptoms. An epileptic attack is usually char- 
acterized by sudden loss of sensation, falling down and distortion 
of the eyes and face, the countenance becomes red and livid, 
there is foaming at the mouth, grinding of the teeth, the features 
are hideously distorted, the tongue is sometimes caught between 
the teeth, there is difficult, slow, deep, snoring respiration, and 
the violence of the attack continues from one to three minutes. 
The patient then makes a deep sighing inspiration, and the con- 
vulsive portion of the paroxysm is ended. These attacks vary 
in duration, severity, and frequency of repetition. After the fit, 
the patient lies insensible for half an hour or longer. When he 
first regains consciousness, he appears confused, complains of 
headache, is stupid, does not reply to questions, but seems be- 
wildered and lost. He does not retain the least recollection of 
what has occurred to him. If he talks, he articulates incohe- 
rently, or if he walks, he staggers like one intoxicated. The 
intervals between the paroxysms become shorter, the convulsive 
attacks increase in severity but may continue for years, to dull 
the intellect and weaken the powers of the body, as well as of 
the mind. 
1297. Causes. The exciting causes may be deep or 
broken sleep, loss of rest, passion, vexation, exhaustion or excess- 
ive venery. Likewise the pi-esence of indigestible food in the 
stomach, retention of morbid matters in the intestines or blood, 
constipation, piles, or uterine irritation. The condition of the 
brain is that of venous congestion; at all events there is a de- 
rangement in the relation between the arterial and venous circu- 
lation within the head, which results in pressure upon the brain 
and suspension of sensation, thought and motion, as regulated by 
the will. The brain inlluences the functions of the spinal mar- 
row, and just as soon as this pressure interrupts the action of 
the brain, the spinal marrow exerts its functional powers very 
irregularly, by the manifestation of disorderly, energetic and 622 
COMMOX SEXSE MEDICAL ADVISER. 
ill-timed muscular movements. Predisposing Causes are,repeated 
attacks of convulsions during the period of infancy, scrofulous 
diathesis, unnatural form of the head, etc. Epileptic convulsions 
may be induced from a diseased condition of the liver, biliary 
concretions, granular kidneys, renal calculi, stones in the bladder, 
or worms in the alimentary canal. Strong mental emotion, flight, 
indulgence in intoxicating liquors, debauchery of all kinds, 
especially masturbation, the retrocession of eruptions, cessation 
of habitual discharges, or profuse and unusual ones, and finally 
tumors of the brain, may all predispose to epilepsy. 
1298. Preliminary considerations to Treatment. From the 
mere enumeration of the many different causes which excite this 
malady, it is evident, I think, that there is no one compound 
which can be a specific remedy for the cure of epilepsy. It is 
hardly presumable that any preparation, no matter how valuable, 
will succeed while the patient continues the bad habits which 
first induced the paroxysms. It is scarcely supposable that the 
remedy which would prove a solvent of biliary concretion, will 
remove stones from the bladder, much less so improve an inher- 
ited scrofulous diathesis as to cure the patient of tumors of the 
brain. On the other hand, is it not utterly inconsistent and con- 
trary to common sense, to believe that medicines used for any of 
the above purposes are calculated to remove uterine irritation, or 
provide against the effects resulting from retrocession of erup- 
tions ? The plain truth is, there is no one specific remedy for all 
cases of epilepsy, but there are specific remedies suitable for each 
curable case. These must be selected with judgment and adap- 
tation, and applied according to the condition of the patient. 
1299. Treatment. The treatment of this terrible dis- 
order may be curative or only palliative. Some of its causes are 
removable, as for example, when it is induced by irritation aris- 
ing from the presence of worms in the intestines, stone in the 
bladder, etc. It is sometimes caused by overloading the stomach 
with improper food, which is continued until an unnatural appe- 
tite imperiously demands-gratification; this morbid craving must 
be restrained if epilepsy would be cux-ed. Again, if it be the 
•result of a disease of the liver, when that organ is restored in its 
functional integrity, the patient is exonerated from the attacks 
of epilepsy. If the blood becomes vitiated, and is gradually EPILEPSY. 
623 
restored to health by alteratives; or if the disease be induced by 
vicious and dissolute habits, these may be reformed and the 
patient recover. It is equally evident that it is a curable malady 
when it occurs in consequence of the disappearance of cutaneous 
eruptions, or from the suppression of customary discharges. 
Likewise, when caused by uterine irritation, if the latter disease 
be remedied, the former can be cured. I might continue illus- 
trations of curable epilepsy, and however difficult or complicated 
a case may appear, there is nothing that can excuse apathy on the 
part of friends, or justify neglect on the part of the physician, 
for in all these and similar cases, there is reason to hope for a 
recovery. 
1300. On the other hand, if the above enumerated causes be 
associated with a scrofulous diathesis, or if the patient inherit a 
predisposition to this disease, his chances for recovery are not 
as promising. Again, when this disease continues until an 
epileptic physiognomy is recognizable, the memory enfeebled, 
fits frequent and accompanied by any form or degree of paraly- 
sis, the recovery is less probable, and the prognosis unfavorable. 
When it depends upon structural disease of the nerves or brain, 
as tumors on the brain, the case is hopeless. 
1301. When the time of an expected paroxysm approaches, 
great care should be exercised lest the patient be suddenly at- 
tacked while carrying a burning lamp, or fall from some danger- 
ous place, strike upon a heated stove or in some similar way do 
himself a great or mortal injury. During a convulsive paroxysm 
the patient should be placed on a bed, and cold, wet cloths 
applied to his head, at the same time allowing him plenty of 
fresh air. It is necessary to establish regularity in all the daily 
habits, otherwise a cure can never be effected. The strictest 
attention must be paid to the diet and the state of the bowels. 
If the lit occurs at the menstrual period, the feet should be 
placed in a hot water-bath, the bowels moved by a warm water 
injection and hot fomentations applied to the abdomen, the 
patient taking freely of my Fluid Extract of Smart-Weed. The 
time of the period should be passed in bed, so that the body 
may not become chilled. 
1302. The diet should be simple and nutritious, but not stim- 
ulating, especially if the patient be inclined to plethora. If 624 
COMMON SENSE MEDICAL ADVISER. 
accustomed to the use of intoxicating beverages, the patient 
ought to renounce them and become a teetotaler. The dress 
should be such as to keep the extremities warm and regular 
exercise should be taken in the open air. It is better to rise 
early in the morning, avoid all excitement or deep emotion, lay 
aside business cares, and be careful not to engage in excessive 
mental or bodily labor. All excesses and irregularities of life, 
of whatever kind, must be strictly abandoned. 
The bowels should be kept regular by the diet if possible. To 
remedy constipation, use fresh vegetables, fruits and my Pleas- 
ant Purgative Pellets. The use of cold water injections will 
also assist in overcoming the torpor of the colon and consequent 
constipation. Rubbing the spinal column with the following 
preparation will be found beneficial : Alcohol, one pint; quinine, 
one drachm; tincture of red pepper, one or two ounces; mix. 
Rub the spine with this compound every night. I shall refrain 
from giving the details of special treatment, which cannot be 
available to the general reader and which must be especially 
adapted to the various conditions and circumstances of each 
patient in order to prove eminently serviceable. It is very evi- 
dent that this class of diseases needs the benefit of an extended 
experience and great familiarity with its many phases and com- 
plications, for, without doubt, hundreds are abandoned as 
incurable who might, under a proper management, not only be 
relieved, but also completely restored to health and usefulness. 
1303. Case I. Miss Anna M., aged 18, accompanied by 
her parents, called to consult me in 1866. She had suffered 
from frequent epileptic convulsions for three years. By ques- 
tioning her parents I ascertained that the convulsions had first 
made their appearance soon after a suppression of the menses. 
The paroxysms were more frequent and severe during the 
monthly efforts to re-establish the suppressed function, yet she 
suffered light attacks at other times. Becoming satisfied that 
the convulsions were caused by the suppression of menstruation, 
treatment was directed to encourage the restoration of that 
function. Powerful “ driving ” medicines were not employed, but 
by a judicious use of uterine tonics, as my Favorite Prescription 
CASES TREATED. EPILEPSY. 
625 
with iron, and, at the proper times, the employment of warm 
sitz-baths 641), the menstrual function was restored, and as 
a result, the convulsions were arrested, and never afterwards 
made their appearance. The lady has since been married and is 
the mother of two bright, healthy children. 
1304. Case II. George P., aged 20, had suffered from 
epileptic convulsions two years. His father consulted me by 
letter, in 1871, and sent a sample of the young man’s urine for 
examination. The microscope revealed the presence of sperma- 
tozoa in the urine, and the father was informed that his son’s 
disease was caused by self-abuse. Having been informed by the 
father of my opinion, George acknowledged that he had prac- 
ticed masturbation ever since he was twelve years of age, but 
was entirely ignorant of its injurious effects. Moral restraint 
was thoroughly exercised over the young man by the father in 
order to prevent him from indulgence in this pernicious practice. 
When the habit of self-pollution is firmly fixed upon a young 
man, it is not always possible for him to summon fortitude and 
self-control sufficient to discontinue the practice. Medicines 
were prescribed and sent for the purpose of arresting the escape 
of semen. Nervines were also used to tone his shattered sys- 
tem. These means, with attention to diet, exercise, bathing and 
other hygienic observances had, within three months, worked a 
wonderful change in the young man’s appearance, as his photo- 
graphs sent me plainly indicated. A continuation of the treatment 
for five months more, with only slight changes to suit the symp- 
toms arising from time to time, resulted in a perfect cure. 
Many young men and women are to-day suffering untold misery 
as the result of the terribly injurious practice of masturbation, 
so generally prevalent among the youth of our land, who are 
ignorant respecting the hygiene of the reproductive organs. For 
this reason I offer no apology for devoting a considerable space 
in this volume to the consideration of this subject. 
1305. Ollier Cases. The list of epileptic cases on re- 
cord at the World’s Dispensary is a long one, and numerous have 
been the cures effected. The treatment has been varied to 
suit individual peculiarities of constitution, and a diversity of 
predisposing and exciting causes. The variations of treatment 
found necessary for the successful management of the disease, 626 
COMMON SENSE MEDICAL ADVISER. 
are so frequent and necessary that I could hardly hope to make 
the consideration of further cases either interesting or profitable 
to the non-professional reader. 
ST. VITUS’S DANCE. (Chorea.) 
1306. St. Vitus’s Dance is an affection of the nervous system, 
and is characterized by involuntary contractions of the voluntary 
muscles. It may affect a part, or the entire body, although it is 
usually confined to the left side. 
1307. Symptoms. Twitchings of the muscles of the face, 
which at first are comparatively slight, but as the disease pro- 
gresses these spasmodic contractions become more decided,and the 
face is twisted into various shapes and forms. The head, in some 
cases, is constantly moving up and down, or from side to side. 
These convulsions (for such they really are) are succeeded by an 
idiotic look, and return again with as much intensity as before. 
It is with great difficulty that the tongue can be thrust out of 
the mouth, and then with a sudden jerk it is as soon withdrawn. 
These convulsions, or contortions, affect the extremities in a 
similar manner, the hands and arms cannot be kept quiet, the 
gait is unsteady, and one foot is merely dragged after the other. 
If one limb be forcibly held, to keep it quiet, some other limb 
will involuntarily move. Strange as it may appear, these con- 
tractions, which cannot be controlled by the will during wake- 
fulness, are very much lessened or arrested by sleep. One writer 
has remarked, “ It would seem that the stimulus of volition is in 
some degree essential to this disease.” If it be long continued, 
it is apt to weaken, or even destroy, the intellectual powers. 
The general health of the patient becomes impaired, the pulse is 
feeble, the pupils of the eyes dilate, the appetite is poor, the 
digestion deranged and the urine highly colored. 
1308. Causes. These are not definitely nor satisfactorily 
understood. It is, by some, thought to be an affection of the 
brain, since the voluntary muscles are alone affected, the intel- 
lectual faculties are impaired, and there is loss of volition, for 
the will fails to control the irregular contractions of the muscles. 
This affection may be due to imperfect nutrition, depression of 
spirits, grief and fright. Some writers have attributed it to 
rheumatic affections, constipation, a morbid state of the blood, ST. VITUS’S DANCE. 
627 
suppression of the menstrual function, uterine difficulties, mastur- 
bation, blows, injuries, or any cause which would give rise to 
nervous debility. Some suppose that it is caused by obstruction 
in the alimentary canal, or by intestinal worms. It rarely occurs 
earlier than the sixth year, and generally between the tenth and 
thirtieth. 
1309. Treatment. It is quite customary to use the 
phrase, “the laws of health,” an expression indicating natural 
ordinances which should have the force of a command. In one 
sense, disease may he considered as the penalty attached to a 
violation of the laws of life. To carry out the similitude of this 
mode of speech, I would say that most disorders are retributive in 
their character. We unconsciously and many times knowingly 
infringe the laws of our being, and disobey the requirements of 
health, until judgment is rendered against us, and our trans- 
gressions are straightway followed by the pains of disease. 
St. Vitus’s Dance need not be singled out as specially illustra- 
tive of this idea, but it points to this moral, viz: Disease is gen- 
erally the sequence of enervating habits. We may neglect to 
cultivate the physical health, to strengthen and invigorate the 
body; we may indulge in idleness and ease, or those practices 
which make us tender and delicate, but by thus degenerating 
the vitality and vigor of the body, the nervous system is weak- 
ened and prepared for the manifestation of this disorder. If we 
would obey nature, we must learn her injunctions, a knowledge 
of which we may gain in two ways, viz: (1.) By the study of 
physiology; (2.) By seeking after the causes of disease. 
These remarks suggest to us the hygienic management of this 
disease. The disorder is a functional derangement of the nervous 
system, showing weakness, a failure of vital power, and a lack of 
the proper endowments of life. The hygienic treatment must 
be sustaining. Pure air, nutritious diet, and cold baths, are all 
essential auxiliaries. Friction upon the surface of the body with 
the warm hand is also very beneficial, and helps to establish the 
general circulation of the blood. After employing these manual 
methods for a week or two, commence taking regular walks, one 
in the middle of the forenoon, and the other in the middle of the 
afternoon, immediately after the bath, and gain on each walk 
from five to ten steps, according to the strength of the invalid. 628 
COMMON SENSE MEDICAL ADVISER. 
The body should be well protected and the extremities warmly 
clad. If the bowels be torpid, make use of boiled cracked 
wheat, and those means advised under the head of constipation. 
In some cases I have prescribed blood-restoratives and anticon- 
vulsive medicines, with the most gratifying success. This disor- 
der, as well as hysteria and epilepsy, is frequently amenable to 
nervines. When caused by derangement of the menstrual func- 
tion, I have generally found my Favorite Prescription sufficient 
to effect a cure. I have cured several cases of this disease, caused 
by masturbation, by employing treatment adapted to control the 
spermatorrhoea which was undermining the constitution. In 
other cases I have had my attention directed, by the symptoms, 
to a morbid condition of the blood, and by the administration of 
proper remedies have been successful in effecting a cure. In 
others, with all of the facilities for investigation, I could dis- 
cover no cause for the distressing convulsive manifestations. In 
such cases the treatment has necessarily been somewhat empir- 
ical, and not attended with the same degree of success as when 
the cause could be discovered. 
NEURALGIA. 
1310. Neuralgia is a term applied to a class of painful affec- 
tions which are attended with no inflammation or perceptible 
change in the structure of the parts involved. The seat of the 
pain is in the nervous matter, and may either be manifested in 
the trunk, or extremities of a nerve. The attack usually com- 
mences gradually (sometimes suddenly), and the approaching 
symptoms are weight, dull pain, or uncomfortable feeling. It 
may announce itself by a sharp lancinating pain, darting and 
tearing away in an excruciating manner, and then suddenly 
ceasing, or the paroxysm may remit, and even intermit, to be 
renewed again at an uncertain interval. 
1311. Neuralgia may put iu an appearance wherever the 
nerves emerge, along their course, or at their minute termina- 
tions. Thus there are various forms, named from the locality 
affected, as neuralgia of the face, skin, muscles, leg, ribs, heart, 
etc. Some people are more sensitive than others, and are there- 
fore more subject to neuralgic pains, which may be distinguished 
from the pain of inflammation by pressure upon the part NEURALGIA. 
629 
affected. If it be neuralgia relief will be obtained by thus doing. 
Neuralgic pain is changeable, often increased by sneezing, or any 
violent movement of the body and sometimes continues in spite 
of treatment. 
1312. Csusses. The causes are very obscure; this disease 
will often manifest itself when the blood is impoverished and the 
diet is innutritious; as Romberg says, “It seems as if pain were 
the prayer of the nerve for healthy food.” It is frequently 
aroused by the passions or by violent emotions, excessive exer- 
cise, lead poisoning, and in consequence of mental depression, or 
from malaria. The paroxysms recur with such regularity as to 
indicate periodicity. It is true we really know but little concern- 
ing the causes and hence the treatment is to a great extent 
empirical. 
1313. The distinguishing symptom is sud- 
den, sharp and darting pain in some part; when in the face, it is 
called tic douloureux/ in the heart, it is termed angina pectoris; 
in the hip and leg, it is known as sciatica, and between the ribs, 
it is designated intercostal neuralgia, which is liable to be mis- 
taken for pleurisy. The pain of neuralgia is so agonizing, 
shooting and cutting that the feeling is described as that of red- 
hot wires piercing the part. 
1314. Treatment. The treatment should have reference 
to the general condition of the patient. We must endeavor to 
ascertain whether the affection be caused by lead poisoning, 
malaria, or if it occur simply in consequence of general debility. 
We should be guided in our selection of remedies by reference 
to the causes. If we discover evidence of the influence of 
malaria, then tonics and antiperiodics are indicated. If from 
lead poisoning, use the white liquid physic, (*[1117). If the 
pain be local, as in sciatic neuralgia, wet a cloth in a rubefacient 
mixture of equal parts of spirits of ammonia, tincture of aconite 
root and chloroform, and hold it for a few moments upon the 
region of pain, just back and a little below the hip-joint. If it 
be located in the neck or back, dry cupping of the parts may 
afford relief. In facial neuralgia, which is sometimes excited by 
derangement of the stomach, a cathartic will at once relieve the 
pain. Electricity will, at times, mitigate the suffering, while at 
others, a spirit vapor-bath will allay the distress. If an anodyne 630 
COMMON SENSE MEDICAL ADVISER. 
be required, use freely of my fluid Extract of Smart-Weed. 
In most cases the general health will be improved and restored 
by taking freely of my Golden Medical Discovery. 
HEADACHE. (Cephalalgia.) 
1316. Headache is not, properly speaking, a disease, but is a 
prominent symptom of very many maladies, and so large a pro- 
portion of mankind is afflicted with it that it deserves a distinct 
consideration. It assumes various forms and should therefore be 
treated under separate and distinct heads. 
1316. Organic Headache. It is frequently difficult to 
determine to which class the various headaches should be as- 
signed. This form, which is due to disease of the brain, is not 
easy to explain. 
1317. Symptoms. The pain, in this kind of headache, 
is located in one place, is continued, deep-seated, severe and in- 
creased either by motion of the head, close mental application, 
any kind of excitement, or by the use of stimulants. Nausea 
accompanied by vomiting sometimes occm-s, but unlike sick head- 
ache it fails to relieve the pain. The memory is often impaired, 
the hearing as well as the vision temporarily fails and paralysis, 
or even idiocy may result. 
1318. Causes. Brain disease—the cause of this headache 
—may be hereditary, and a person be predisposed to it, or it 
may be occasioned by injuries upon the head from blows, contu- 
sions, etc. In advanced age, the pain is persistent, doubtless in 
consequence of morbid changes occurring in the structures of 
the brain. One author has remarked: “At this period of life 
the energy of the nervous system is diminished, the stomach and 
bowels are less sensitive, the muscular tissue is no longer reno- 
vated with the ceaseless activity of adult life, and thickenings, 
indurations of, and morbid deposits in, blood-vessels and other 
tissues, are very common.” 
1319. Nervous Headache is common to persons pos- 
sessing an encephalic temperament, for they are usually very 
sensitive. 
1320. Symptoms. There is severe throbbing pain in the 
top of the head and a swimming or dizzy sensation, dullness of 
mind and consequent loss of memory; the eyes are sunken, the HEADACHE. 
631 
sight dim, the pulse low, the cheeks pale and the bowels consti- 
pated; the patient is low spirited, has cold hands and feet and 
suffers from general debility. Sometimes the attacks are sudden, 
the vision is impaired and the headache increased by keeping an 
erect position, while a recumbent posture diminishes the violence 
of the pain. 
1321. Causes. This form of headache may be due to ex- 
cessive exercise, improper diet, exposures to cold, variations of 
temperature, impure atmosphere, loss of sleep, debilitating dis- 
charges, self-abuse, etc. It is also incident to persons of seden- 
tary habits, or those who closely devote themselves to mental 
pursuits. It may be the result of taking opium, alcohol or 
strychnia. 
1322. Bilious Headache may arise (1) from an ex- 
cessive amount of bile in the blood, or (2) from an immoderate 
secretion of bile. 
1323. Symptoms. Pain in the head, especially in the 
forehead and over the eyes; the skin is of a jaundiced hue; the 
tongue is coated with a yellow fur and the taste is bitter. There 
is nausea and vomiting, which partially relieves the patient, on 
account of a portion of the bile being ejected from the stomach. 
1324. Causes. This kind of headache is doubtless due to 
a morbidly active condition of the liver. Those who are intem- 
perate in the use of food, or drink, or who are habitually care- 
less of their health are liable to suffer from this kind of headache. 
1325. Sick Headache is another form of this affection, 
to which nervous persons and those of sedentary habits are 
subject. 
1326. Symptoms. There is a feeling of dizziness, pain 
in the forehead and temples, at first comparatively slight, but at 
length it becomes very severe, the vision is blurred, there is 
nausea followed by vomiting, after which the patient is inclined 
to sleep. Upon waking, he finds that his headache has disap- 
peared, leaving a soreness in the affected part of the head. The 
breath is foul, the tongue coated yellowish white, and there is a 
general chilliness of the body. 
1327. Causes. Immoderate indulgence in the use of spir- 
ituous liquors, indigestible articles of food, insufficient sleep, 
sedentary habits, constipation, mental anxiety, excitement of any 632 
COMMON SENSE MEDICAL ADVISEE. 
kind, insufficient exercise, or if plenty of exercise be taken, eating 
too soon thereafter. Headache may arise from a plethoric con- 
dition of the system, in which case there is severe pain in the 
temples and forehead, or in the back part of the head, at- 
tended with dizziness and dullness of vision; the respiration is 
difficult, the action of the heart unnatural, the pulse full and 
quick, the tongue coated white, the appetite good, but the bowels 
are constipated and the urine is highly colored. Some of the 
elements which enter into the composition of the urine, may be 
in excess or even deficient, and the action of the urinary organs 
may be abnormal, thus producing another form of headache. 
This is dull and heavy, the appetite is good, the bowels are in a 
healthy condition, the pulse is quick and low, but there is a feeling 
of general languor and indisposition. Those persons who are 
suffering from syphilis and have taken mercurials, are sometimes 
affected with headache, due to the action of these medicines. 
The pain is intense upon the top and sides of the head, and some- 
times the skin over the painful part becomes raised. There is 
also more or less tenderness in the roof of the nose, sore throat 
and pain in the legs. Headache not unfrequently attacks those 
who have rheumatism. In this form the pain is dull, and located 
in the temples and back of the head; there is sometimes giddi- 
ness, drowsiness and soreness, as well as tenderness of the painful 
parts. 
1328. Treatment. Concerning the management of all 
of these headaches, we may say that it is important to keep the 
bowels open, the skin clean, the kidneys active and the circula- 
tion of the blood well determined to the surface and extremities 
of the body. It is also necessary, in order to secure these impor- 
tant results, that the kind and amount of clothing be suitable, 
the daily habits regulated, and all excesses avoided. The diet 
should be moderate and easy of digestion; the patient should 
refrain from indulging in rich gravies, late suppers, or stimula- 
ting beverages. In organic headache not much can be suggested, 
except the hygienic recommendations above given. In nervous 
headaches, caused by overdoing, rest is necessary to recuperation. 
If produced by debilitating discharges, then a tonic course of 
treatment is indicated. If it be incident to a sedentary occupa- 
tion, causing costiveness, exercise more, eat boiled cracked wheat INSANITY. 
633 
once a day and regulate the bowels with my Pleasant Purgative 
Pellets. The habits should be strictly governed, and temperance 
observed in all things. In bilious headache, the bowels should be 
acted upon by my Pellets, followed by my Golden Medical Dis- 
covery. Sick headache may result from some indiscretion in 
eating, anxiety, or loss of sleep, and may be relieved by taking an 
alkali, a Sedlitz powder, a Pellet or a stimulant. In a plethoric 
condition of the body great care must be taken to control the 
appetite. Medicines will furnish only temporary relief, and un- 
less the desire for food be restrained, it is useless to resort to 
medicinal treatment. Likewise the amount of urine daily excreted 
should be estimated, for headache often results from a retention 
of some of the urinary elements in the blood. If the amount 
excreted be small, this circumstance should lead to a consultation 
with some physician; or, if syphilitic poison be lurking in the 
blood, then the use of the Golden Medical Discovery and Pleas- 
ant Purgative Pellets is proper. If these do not bring relief, the 
case should then receive a more critical examination by some com- 
petent physician. If the reader does not obviate the pains of 
headache by a strict observance of the hygienic rules which I 
have given, a skillful physician should be consulted. 
1329. In treating of the human temperaments I classified 
them as vital and non-vital 192). I also made regional 
divisions for the purpose of illustrating the cerebral tendencies, 
and representing the antagonizing powers of the brain (Figs. 68, 
71 and 78). I assumed that mental as well as physical perfec- 
tion consists in the balance of all the faculties, and that any 
excess or deficiency results in derangement. A justifiable infer- 
ence from such a hypothesis is, I think, that mental derangement 
may either result from the peculiar formation of the physical 
system, or from some functional disturbance. It does not appear 
unphilosophical to hold that the volitive region sustains an 
adverse relation to that of feebleness, and as the former, in the 
logic of thought, is the region of sanity, so the latter, accordingly, 
represents the region of insanity. 
INSANITY. 
1330. To the former region I assign firmness, manliness and 
self-restraint; to the latter, indolence, morbidity and debility. No 634 
COMMON SENSE MEDICAL ADVISER. 
one denies the proposition that every morbid state influences our 
imaginative, observant and reflective faculties. Disease makes 
us unreasonable, mars the process of thought, and when the en- 
feebling organs preponderate, the natural tendencies of which are 
despondency, fitfulness, rash impulsiveness, morbidity, mania 
and suicide, we begin to think that we have the representation of 
an insane temperament or diathesis, which may be hereditary. 
1331. It is well-known that morbid structural changes may 
take place in the substance of the brain, without producing any 
derangement of the mental faculties, while numerous post-mor- 
tem examinations have detected no unnatural appearances in the 
brain, although insanity had existed for many years. Since 
pathological anatomy does not furnish the evidence of struc- 
tural changes in the brain to account for derangement, we may 
infer that insanity is due to organic development, modifying and 
perverting its functions. 
1332. I am of tlie opinion that the tendencies to insanity 
are associated with both the basilar and feeble organs, which 
strangely combine the action of the violent and morbid faculties. 
The entire base of the brain is developed not only laterally, but in- 
feriorly, at least sufficiently so to pervert and distort the processes 
of reason. This development is indicated by the breadth and 
depth of the lower jaw, as well as by the prominence beneath. 
Cretinism is a species of idiocy commonly accompanied by an 
enormous goitre, it is hereditary, and may be found in Switzerland. 
You may see in the valleys of the Pyrenees and Alpine mountains 
these unfortunates, in all stages of mental degradation, little 
better than the beasts of the field, helpless, dependent and 
limited to the exercise of the animal propensities. This may be 
regarded as a type of organization indicating insanity. 
1333. We can easily decide whether the derangement arises 
from the abnormal development of the basilar organs of the 
middle or posterior base of the brain, for in the former case we 
have incoherence, dejection, feebleness, imbecility and idiocy; 
in the latter, morbid violence of passion, vehement propensities, 
vicious manifestations and raving madness. Idiotism and imbe- 
cility frequently appear in childhood; because congenital they are 
associated with lymphatic tendencies, whereas the active symp- 
toms of insanity, dependent upon the growth of the posterior, INSANITY. 
635 
inferior faculties, do not develop until toward the evolution 
of puberty. During the period of youth and somewhat later, 
the derangement of mind assumes a more acute character than 
in middle age; the type of this disease is then more chronic, 
and frequently complicated with diseases of the stomach or other 
visceral organs. 
1334. It is often said that the exercise of the religious facul- 
ties causes insanity. This I regard as a mistake. That a per- 
version of them may occasion insanity, no one will question; but 
a legitimate exercise of the religious faculties restrains the ani- 
mal, and thus prevents moral and physical derangement. Reli- 
gious delusions cause insanity, because these strongly appeal to 
the semi-animal faculties fear and anxiety, which co-operate 
with gloom, doubt and terror, until the forebodings of evil in 
the future state produce insanity. People are slow to learn that 
the terrors of the law do not inspire the emotive faculties, and 
love never predisposes to insanity, unless it be itself beguiled and 
betrayed by the animal propensities. Those who exercise an 
abiding faith, a confident hope, and are full of tender charity, 
rarely, if ever, become insane. On the other hand, to those who 
doubt the goodness of God, and turn His love into malignity, 
faith becomes unbelief, hope is supplanted by fear, and all 
their bright prospects, blackened by anguish, show the tortures 
of the blind, incensed and maddened passions. They rush on 
from desperation to suicide—into the black darkness and horror 
of an unknown future. 
1335. The reader will obtain a more satisfactory view of this 
subject by reading 165, 168, 169, 170 and 171, which show 
that when the basilar functions are unduly aroused, the digestive, 
as well as the mental functions, become deranged. Any treat- 
ment, therefore, for insanity, which overlooks or neglects the 
condition of the digestive organs, will fail of success. 
1336. Causes. The blending of certain temperaments in 
marriage, results in epilepsy, mental derangement, malformation 
of the body, idiocy, etc. Peculiar temperaments are not only 
most powerful in developing, but may be considered as predis- 
posed to, insanity, because they indicate an organic combination 
of elements which gives rise to this disease. The cause, then, 
of insanity may be found in organic conditions, which not only 636 
COMMON SENSE MEDICAL ADVISER. 
interfere with health but with the functional processes of the 
mind. Some persons are so constituted that they are easily de- 
ranged physically and mentally, while others continue perfectly 
sane under the most trying circumstances of life. Disease of the 
stomach or liver will cause insanity in some persons, while others 
will waste away and die from structural lesions of these organs, 
and exhibit no symptoms of alienation of mind. 
1337. The causes of insanity may be organic, functional, gen- 
eral, local, moral, physical, predisposing or exciting. The func- 
tions of the mind are greatly influenced by those of the body. 
These in turn are affected by climate, age, sex, temperament, 
mode of living, disease, and all the vicissitudes of life. Fright in 
infancy, a blow upon the head, suppression of the catamenia, of 
hemorrhoidal discharges in both sexes, or of acute eruptions; in- 
flammation, leucorrhoea, excessive venery, masturbation, hemor- 
rhage, derangement of the circulation, cold, or anything that 
perverts the secretions; intestinal irritation, unlcind treatment, 
neglect, chronic inflammation of the digestive organs, all may be 
mentioned as prominent causes of insanity. Men are frequently 
made temporarily insane by liquor, and when the habit of using 
alcoholic beverages is confirmed, they are led into excesses, de- 
bauchery and crime by the moral and physical derangement 
thereby produced. Women are more emotional than men, con- 
sequently when love terminates in passion, disappointment and 
jealousy, it wholly upsets dignity, propriety, self-respect and 
reason. When the basilar faculties are disordered, the insane 
are boisterous, profane and obscene; they will steal, lie, gratify 
their propensities and talk and act in the most presumptuous and 
audacious manner imaginable. After the ravings, reaction may 
take place, the imaginative powers become vividly sharp and 
active, and the thoughts and language may flow “ in a placid yet 
rippling stream of taste and fancy.” They often sing, pray and 
talk almost as if divinely inspired. But the least provocation 
will suddenly turn all beautiful expressions and interpretations 
of these waking dreams and heavenly visions into frightful im- 
precations and awful maledictions that make one’s blood run 
cold. 
1338. §yiliptOIll§. The symptoms that indicate aberra- 
tion of mind may at first be very slight and trifling. They INSANITY. 
637 
may manifest disturbance of the feelings and disorder of the 
propensities and the patient becomes gloomy, dispirited and 
apprehensive. There seems to be a morbid perversion of the 
perceptions, affections and active powers; he shuns his nearest 
relatives, is jealous, suspicious, capricious, commits theft, has a 
propensity to mischief, hides away valuables, has an impulse to 
destroy life, in short, acts from false impressions. He is restless, 
whimsical, easily excited, eccentric, extravagant, disturbed in 
mind, becomes irregular in his habits, cannot sleep, loses his 
appetite and is easily provoked. These symptoms may be ac- 
companied by delusions, as the hearing of strange sounds and 
imaginary communications, or conversing with unseen persons. 
He fancies that he has lost a leg, an arm or is headless, that he 
represents some animal, personates some beautiful character, or 
is changed to some other form and sees whatever the imagina- 
tion conjures up. Those subject to the last named delusion are 
thus aptly described by Pope: 
“ Unnumbered throngs on every side are seen, 
Of bodies changed to various forms by spleen; 
Here living tea-pots stand, one arm held out, 
One bent; the handle this, and that the spout; 
A pipkin there, like Homer’s tripod walks; 
Here sighs a jar, and there a goose-pie talks.” 
He shows strange likes and dislikes, the judgment is perverted, 
he loses interest in the common affairs of life, experiences optical 
illusions, suddenly and causelessly laughs or cries, refuses food, 
expresses erroneous ideas, is disposed to court solitude, hides 
away from observation, divests the body of clothing, looks 
anxious, silly and stupid, or has an oblique look, manifests quick- 
ness of perception, sharply scans the motives of those around him, 
etc.; these and similar symptoms indicate mental derangement. 
When the inception of insanity is insidious and its progress 
slow, the brain and abdominal organs are both more or less dis- 
eased. It is important to discover the early symptoms, such as 
absence of mind, or the alteration of manner denoting mental 
derangement, and arrest them by proper treatment, in order that 
it may not become a case of confirmed insanity. Seek early the 
best medical advice, for every day, every hour lost, is of vital 
moment. 638 
COMMON SENSE MEDICAL ADVISEE. 
1339. Prognosis, is the judgment formed by the physi- 
cian as to the progress, curability, and termination of the disease. 
His opinion depends upon whether insanity be an organic disease 
or a functional disturbance of the nervous system, and he should 
also take into consideration the severity of the attack and the 
power of the constitution to resist it. Nothing is more apparent 
than that patients readily improve under the treatment of one 
physician, when they receive no benefit whatever from others. 
1340. If the aberrations be merely whimsical, transient and 
occasional, however wild or absurd they appear, the prognosis 
is favorable. When inebriety is the cause of insanity, it is cura- 
ble. So likewise when patients are under the dominion of 
passion, are perverse, and yet the mental faculties are not im- 
paired, the prognosis is favorable. When dislike and distrust of 
friends are succeeded by a desire for their visits and companion- 
ship, it is a good symptom. If those who are mischievous and 
disposed to thievery, or to destroying things, receive early treat- 
ment, they are generally curable, although when the propensity 
to mischief is hereditary and very strong, the disease is fre- 
quently incurable. When the hallucinations are absurd, and yet 
the reasoning faculties are good, the case is curable. If the 
attack be sudden and violent, or follow the cessation of dis- 
charges, or disappearance of an eruption, it is amenable to treat- 
ment; or if it follow from the suppression of hemorrhoidal 
discharges, or occur in consequence of exposure to cold, or from 
loss of sleep, fright, etc., proper treatment promises restoration. 
1341. Insanity indicating difficult management is apt to fol- 
low a fever of an inflammatory type attended with considerable 
cerebral excitement, especially if this invasion be insidious and 
progress slow, or when it is preceded by an attack of paralysis 
or epilepsy. If the patient appears conscious of the absurdity of 
the delusion under which he labors, a permanent recovery is 
doubtful. If the perversion of the judgment arises from the 
influence of the passions, treatment will generally be successful, 
except when it is deeply rooted and fixed. This indicates incur- 
able monomania. 
1342. The prognosis is doubtful and unfavorable when the 
attack is insidious, gradual and slow, connected with defect of 
memory, forgetting his own name, country, and trade, his place INSANITY. 
639 
of residence, or recollects certain circumstances of a transaction, 
but not all, or when the recollection of past events gradually 
fades from the mind. Likewise, when the patient assumes that 
he ranks high in life, and yet retains a correct idea of his personal 
identity; if the natural tone of the voice be materially altered, 
the articulation indistinct, the swallowing difficult; or if the 
patient turn a deaf ear to all that is said to him, and yet is intent 
upon listening to imaginary communications; when melancholy 
succeeds furious mania, or if there be a constant clapping of the 
hands, drumming of the feet, sitting all day in the same place 
and position. Whenever insanity is complicated with disease of 
the lungs, or is manifested by a constant biting of the nails, the 
features constantly bearing the impress of terror,—these are 
circumstances and symptoms which lead to an unfavorable 
prognosis. 
1343. Treatment. The treatment of lunatics should 
consist in hygienic observances, moral management and the 
administration of proper medicinal agents. I shall dwell upon 
the first two considerations embraced in the treatment above 
mentioned,—the latter belongs more especially to the province 
of physicians, who are already qualified and need no particular 
suggestions from me. 
I may remark concerning the diet of the insane. They are 
usually violent or preternaturally active, and excess of nerv- 
ous excitement requires a greater abundance of food, which 
should be of a nutritious quality. I have treated those who, 
even when their appetites were good, would refuse to eat, and 
could only be persuaded by repeated, gentle solicitations. 
1344. Beef and mutton are allowable, but pork, fresh or 
salted, and veal, are generally objectionable. The diet must be 
regulated to suit individual peculiarities, as Avhat will do well for 
one may be entirely unsuited to another. Graham bread, biscuit 
and gems, cracked wheat, baked apples and stewed prunes, are 
grateful articles of diet and tend to produce regularity of the 
bowels. The supper should be light. Occasionally fish or oysters 
may be cooked; white bread and johnny-cake add to the variety 
of substantials. It is important that the diet keep the bowels 
regularly open and sustain the strength of the patient. 
1345. The moral treatment of the insane requires that the 640 
COMMON SENSE MEDICAL ADVISER. 
physician obtain the confidence of his patient. lie must be 
guarded in all of his communications, candid, frank, scrupulously 
truthful, and avoid all appearance of strategy or double-dealing. 
He should make few promises and fulfill each one literally; he 
should consider all engagements and pledges sacred, and never 
deceive his patient in manner or speech, but be sincere, confident 
and perfectly reliable. The insane require accurate, faithful 
and honorable treatment, otherwise moral management is a 
misnomer. 
1346. Four-fifths of all who are mentally deranged can be 
restored to reason if the malady be properly managed in its earli- 
est stages. It is essential that the insane be treated with gentle- 
ness, kindness and respect, that their minds be diverted and they 
removed from all exciting causes. They should be allowed 
amusements, diversions, innocent games and means of enjoyment, 
and as soon as possible be taken from their families or homes, 
and placed under proper remedial management. They may be 
allowed (according to the judgment of the physician) books, 
music and checkers to occupy the mind, or be permitted to engage 
in some light exercise, as playing croquet, gardening, needle- 
work, and such employment as may be of benefit to the body. 
1347. Never make the insane the subject of remark, mirth or 
derision, no matter how absurd they may talk or act. If they 
are violent, they should be gently and carefully restrained and pre- 
vented from doing themselves or others injury. Lunatics often 
entertain a high sense of honor and delicacy; even those who, 
in their moments of excitement, may talk very unbecomingly, in 
their lucid intervals will remember any breach of decorum or 
impropriety of speech in those having charge of them. Always 
treat the insane with calmness, firmness and patience, and never 
betray any sign of impatience, or the least wavering of the 
determination. Always show kindness, courage and perfect self- 
control, and never give an order unless it be strictly enforced. 
Attention must be paid to cleanliness, regular exercise, diet and 
occupation of the invalid, in short, all of the symptoms and sur- 
roundings must be carefully considered when medical treatment 
is instituted. I shall not enter upon the details of remedial 
conduct, nor discuss the relative value of medical agents, since 
these disorders and their management constitute one of the INSANITY. 
641 
specialties of medical practice with all classes of physicians. I 
have devoted much time to the investigation of these derange- 
ments, and find them just as amenable to treatment as any 
disease. 
1348. One fact I wish to impress upon all, that most patients 
treated for insanity are too soon dismissed as cured. Unless the 
treatment is continued they are very liable to relapse. It is 
a great mistake to omit treatment when a promising lucid 
interval has been reached. The natural predisposition, or the 
functional tendency, may yet remain, and the patient needs to 
continue a course of hygienic and medicinal treatment long after 
the period of apparent convalescence is established. All per- 
version of functions, in consequence of morbid changes in the 
secretions must be remedied, and the removal of noxious mate- 
rials from the blood must take place gradually, and hence the 
use of remedies should be continued for a long time, until the 
general health becomes fully confirmed and thoroughly estab- 
lished. 
CASES TREATED. 
1349. Case I. Mrs. P., of Pennsylvania, became so de- 
ranged in 1870, that her friends made preparations to take her 
to an insane asylum. She also suffered from catarrh, and was 
persuaded to use Dr. Sage’s Catarrh Remedy, associating with it 
constitutional treatment, and, wonderful to relate, it cured her 
of her insanity, and her health has continued excellent ever since. 
1350. Case IS. Miss E. S., was insane four years, had 
been an inmate of the Utica Insane Asylum, and several physi- 
cians had said that she could never be cured. In April, 1873, 
I was called to attend her, and from the symptoms and history 
of the case, came to the conclusion that the uterus and ovaries 
were the centres of irritation, for the menses had not appeared 
for a great length of time. Accordingly, I gave my Favorite 
Prescription, although it was with great difficulty that she could 
be induced to take any medicine; in fact, it had to be mixed with 
her food. I also gave her my Golden Medical Discovery, and 
in due time, she became rational. In her case (as in similar 
ones), to insure a permanent cure, it was necessary to persevere 
in the use of medicines. If treatment be discontinued too soon 
the patient will surely relapse. 642 
COMMON SENSE MEDICAL ADVISER. 
1351. Case III. Mrs. M. S., had become insane and re- 
garded all her relatives as enemies who had entered into a 
conspiracy against her, and she thought the worst one of all was 
her husband. She was placed under my treatment, and in four 
months went home entirely rational. I continued her treatment 
until she seemed to be fully restored to health, and she has re- 
mained well for the last five years. 
1352. Case IV, In 1874, a young man from the South 
presented himself for treatment at the World’s Dispensary, his 
ill health and derangement of mind being caused by the habit of 
masturbation. He was very excitable, wild, and impulsive, and 
his imagination and judgment were both perverted. He insisted 
that his testicles were gi*eatly enlarged; that each one was nearly 
or quite the size of his fist. Upon examination, I found them less 
than the ordinary size. I gave him the appropriate treatment, 
and in a few months he regained his reason, health and strength. 
I have treated many cases of mental derangement, produced 
by indulgence in this degrading habit, and, were it necessary, 
might refer to a long list of those who have been permanently 
cured. 
1353. Case V. Miss A. II—, a teacher in a seminary, and 
a lady of excellent attainments, had labored hard, mentally, to 
advance the interests of her pupils, when, from overdoing, relig- 
ious excitement, and taking cold, she became suddenly and 
acutely deranged. She was wild with excitement for a few 
days, would tear off her clothing, hide herself away, and finally, 
had to be restrained from doing violence to herself and others. 
This state was succeeded by apathy, loss of speech and dementia, 
and she would pass her urine and faeces in the bed. She was 
attended by skillful physicians, but they did not succeed in re- 
lieving her of any of her symptoms. About a month after this 
attack, she was brought to me for treatment. She had not 
spoken a word for two weeks, nor did she seem to understand 
what was said to her. Finally, under my treatment she began to 
to recover; but even after she regained her speech, she could not 
tell her letters. Slowly her consciousness and knowledge returned, 
and six months from the time of the attack, she returned home 
as a convalescent. She continued to gain in health and strength, 
though it was nearly or quite a year before she fully recovered. DISEASES OE THE EYE. 
643 
She is now married, has several children, and considers herself a 
robust and healthy woman. I might enumerate many cases 
which I have treated for this disease, but the subject of insanity 
has already exceeded the limits assigned it; I therefore omit 
further reference to cases. 
DISEASES OF TIIE EYE 
1354. The eye is subject to numerous diseases which, although 
rarely fatal, yet occasion great inconvenience and suffering, and 
require skillful treatment. 
1355. The term 44 Ophthalmia ” may be applied to 
all inflammations of the eye, but is usually restricted to inflam- 
mation of the conjunctiva—the membrane which covers the ex- 
ternal surface of the eyeball and the inner surface of the lids. 
1356. As prefatory to this subject, I desire to impress upon 
the mind of the reader the important fact, that these maladies 
are not merely local departures from health, but are generally 
associated with constitutional disorder. The prevailing notion 
that they are strictly local derangements and require only local 
applications, is altogether incorrect, and the neglect of constitu- 
tional treatment will result in a failure to cure these affections. 
The use of “ eye-waters,” “ eye-salves,” and kindred preparations, 
without reference to constitutional treatment, will generally 
prove to be of no benefit whatever. 
SIMPLE INFLAMMATION OF TIIE EYE. 
(Catarrhal Conjunctivitis.) 
1357. This disease, also called “Catarrhal Ophthalmia,” is 
the most simple form of inflammation to which the eye is subject. 
1358. Causes. It is usually the result of cold, suppressed 
perspiration, sudden changes in the temperature, heat, smoke, 
intensity of light, extension of the inflammation of the mucous 
membrane of the nose and irritation from dirt or foreign bodies. 
Some persons are predisposed to these attacks at certain seasons 
of the year, without any apparent cause. By using the same 
towel it may be communicated from one person to another. 
1359. Symptoms. At first there is a sensation of dry- 
ness and smarting, as though dirt were in the eye. Soon that 
organ becomes swollen and is more or less painful; there is 644 
COMMON SENSE MEDICAL ADVISER. 
headache, intolerance of light, a profuse lachrymal secretion, and 
if the inflammation continue, it terminates in a muco-purulent dis- 
charge. On separating the lids the eye appears swollen, red and 
angry. In severe cases there is more or less fever. When this 
inflammation is neglected, or improperly treated, it is apt to 
result in some form of chronic disease. If small blisters appear 
on the eye, the disease is termed Phlyctenular Conjunctivitis, 
if ulcers, it is called Pustular Conjunctivitis. 
1360. Treatment. It must be remembered that this 
disease involves constitutional derangement, and should be 
treated by attention to the general as well as the local disturb- 
ance. First, give a brisk cathartic, after which the spirit vapor- 
bath and mustard foot-bath 630, 640) should be employed. 
The sweating which they produce must be continued with 
diaphoretics 548) and small doses of aconite 596) or vera- 
trum 597). Give one of ray Purgative Pellets three or four 
times a day. If the patient be feeble, the constitution badly 
broken down and the powers of life reduced, then tonics rather 
than sedatives should be used, e. g., iron 618) and quinine 
496). As soon as the active symptoms begin to subside, 
alteratives should be given, in which case my Golden Medical 
Discovery will be found very efficacious. 
1361. Keep the eye well cleansed with tepid water, or milk 
and water, exclude all light, and drop into it every three hours 
the following lotion: Take fluid extract of aconite leaves, 
one drachm; fluid extract of belladonna, one-half drachm; water, 
one ounce; mix. After a few days, mild astringent lotions may 
be employed, for which purpose a weak infusion of hydrastis 
613), or witch-hazel 518), or one grain of white vitriol 
(sulphate of zinc) in two ounces of pure water, are among the 
most useful. 
1362. In the Phlyctenular or Pustular form, there is always 
a depravation of the general system, which requires alteratives 
and tonics. My Discovery and Pellets should be administered, 
and may be alternated with quinine and iron. The same local 
remedies recommended in the treatment of simple inflammation, 
may be used in this ease; also a solution of one grain of nitrate 
of silver in one ounce of rose-water, applied to the eye three times 
a day, will be found beneficial. DISEASES OF THE EYE. 
645 
PURULENT INFLAMMATION OF THE EYE. 
(Purulent Conjunctivitis.) 
1363. This disease, also frequently called Egyptian or Mili- 
tary Ophthalmia, progresses with great rapidity. The inflam- 
mation is intense, and all the symptoms of the simple form are 
greatly aggravated. The active stage is short, the swelling of 
the eye is extensive, and pus (matter) is produced in great abund- 
ance. The cornea 135) is liable to be penetrated by ulceration 
or it may become opaque, and the sight be greatly impaired or 
entirely lost. There are two other forms of this disease, known as 
Gonorrhoeal Ophthalmia and Ophthalmia Infantium Pundenta. 
1364. CaiSSCS. Purulent Conjunctivitis may occur spon- 
taneously in the adult, or the simple form may become purulent 
from neglect or improper treatment, or it may arise from local 
irritation. It is usually caused by contagion, since it is commu- 
nicated by wiping on the same towel, or in any way by which a 
particle of matter can be conveyed from the eye of one person to 
that of another. It sometimes occurs as an epidemic. 
1365. IHag’IIOSts. The symptoms are similar to those of 
the simple form of conjunctivitis, though much more intense, and 
there is more constitutional disturbance. The eye is enormously 
swollen and matter freely flows from between the lids, as illus- 
trated by Fig. 156. If the lids be 
separated, the eye will be seen to 
be full of pus (matter), and if 
wiped or washed away the mem- 
branes will appear intensely red, 
the blood-vessels very much swol- 
len, and perhaps numerous small 
points of ulceration will be seen. 
The chief danger lies in the lia- 
bility of the cornea being des- 
troyed. 
1366. Treatment. This 
must be active from the outset, 
and well persisted in, or the eye 
will be destroyed. Confine the patient in a well-ventilated but 
darkened room. Make his surroundings hygienically perfect. 
Fig. 156. 
Purulent Conjunctivitis. 646 
COMMON SENSE MEDICAL ADVISER. 
Bathe the eye frequently with tepid water, or milk and water, 
and cover it lightly with cloths wet in the same, changing them 
often. Never bind anything heavy over an inflamed eye so as 
to keep it warm, as all such applications aggravate the inflamma- 
tion and in this disease favor suppuration. If only one eye be 
involved, care should be taken to protect the other, as well 
as the eyes of the attendants. Give a brisk cathartic, and if 
the tongue continue foul, repeat it as often as necessary, and 
throughout the disease give one of my Purgative Pellets every 
four or six hours, unless they move the bowels too frequently, 
when the interval should be extended. Use the spirit vapor-bath 
(*f 630) and if the pulse be quick, full and hard — symptoms of 
high inflammation — give such sedatives, as aconite 596), or 
veratrum 597), in appropriate doses. The diet should not be 
stimulating. If the general health of the patient be impaired, 
alteratives and tonics must be used, and a more nutritious and 
generous diet allowed. 
1367. locally, use the tepid water bath often, keeping the 
eye well cleansed. Various washes have been advised, as two 
grains of white vitriol (®|[ 504) in one ounce of pure w'ater, or 
nitrate of silver in the same proportion, to be used two or three 
times a day, until the virulent character of the disease is over- 
come. Antiseptic lotions are of great value. Permanganate of 
potash 505), three grains to an ounce of pure water, applied 
freely several times a day, is unsurpassed in the early stage. A 
solution of one grain of the sulphate of atropia 483) in one 
ounce of rose-water, should be used, two or three drops being 
applied twice a day to keep the pupil dilated. Always cleanse 
the eye with tepid water before making any application. The 
services of a skillful oculist should be secured, if the disease does 
not quickly yield to the above treatment. 
1368. Gonorrhoeal Ophthalmia. This is caused by the intro- 
duction of gonorrhoeal matter into the eye. It is the most violent, 
rapid and destructive form of ophthalmia known, and often ruins 
the eye. The symptoms are similar to those of the preceding 
form, though much more rapid in their development and more 
destructive in their tendency. If the patient have gonorrhoea 
the diagnosis is simplified. 
1369. Treatment. The treatment does not materially DISEASES OF THE EYE. 
647 
differ from that advised for simple purulent conjunctivitis, but 
must be very active. Astringent lotions of nitrate of silver or 
sulphate of zinc may be used as heretofore recommended, or an- 
tiseptics may be employed with advantage, as the permanganate 
of potash, five grains to one ounce of water. No time should be 
lost in securing the services of a physician of large experience in 
treating this disease. 
PURULENT OPHTHALMIA OF NEWBORN CHILDREN. 
1370. This affection usually occurs soon afterbirth, ancl may 
be caused by an acrid condition of the vaginal secretions of the 
mother; harsh washings with soap, sponge or cloths, by careless 
nurses; exposure to strong light, or cold; or it may be communi- 
cated from one child to another. Overcrowded tenements, poor 
ventilation, insufficient nourishment and scrofula are predispo- 
sing causes. 
(Ophthalmia Infantium Purulenta.) 
Although this is classed with the purulent variety it is gener- 
ally very mild in its character. It can usually be recognized by 
the swelling of the eyes, intolerance of light and purulent 
discharges. 
1371. Treatment. This should consist in cleanliness, 
ventilation, good nourishment, washing the eyes with tepid milk 
and water, and applying light, wet cloths to them. Mild astrin- 
gent lotions should also be dropped into the eyes, as a weak 
infusion of witch-hazel 518), or hydrastis (1" 613). Simple 
rose-water is often sufficient, or one grain of sulphate of zinc, 
added to four ounces of rose-water maybe employed. 
One grain of permanganate of potash (®505) to two ounces of 
pure water is excellent. With this treatment, the disease gen- 
erally terminates favorably in from two to six weeks. 
SCROFULOUS INFLAMMATION. 
(Scrofulous Conjunctivitis.) 
1372. The course of this disease is usually slow, and recovery 
postponed, on account of the enfeebled condition of the consti- 
tution. It may affect all parts of the eye, and under the old 
fashioned treatment was rendered exceedingly intractable, but, 648 
COMMON SENSE MEDICAL ADVISEE. 
thanks to modern medical advancement, it can now be controlled 
as well as other forms of inflammation. 
13V3. The immediate cause of scrofulous conjunctivitis is 
anything which is capable of exciting inflammation. The scrof- 
ulous diathesis is a predisposing cause. 
13V4. Symptoms. Ordinarily these do not differ ma- 
terially from those of the acute form of simple conjunctivitis, 
though they are less severe. The lachrymal secretions (tears) 
are excessive and run over the cheek. There is intolerance of 
light, the eyes are spasmodically closed, the brows depressed, the 
cheeks drawn up, and the child involuntarily covers his eyes 
with his hands, since the light cannot be endured. On sepa- 
rating the lids, which offer considerable resistance, the tears 
escape. The inside of the lid as well as the eye is red and 
swollen, with here and there pinkish colored blood-vessels run- 
ning toward the center. The membrane covering the eye is 
frequently thickened and ulcers are apt to be found on the 
cornea, which may become hazy and opaque. 
13Vo. Treatment. Heretofore the treatment of scrofu- 
lous ophthalmia has been difficult and unsatisfactory, partly from 
the opposition which the child offers to an examination, or the 
application of remedies locally, and partly from the fact that the 
local disease depends upon a constitutional affection which has 
been difficult to overcome. Under these circumstances the cure 
has necessarily been delayed, if not entirely prevented. Al- 
though immediate benefit may not be received from the treat- 
ment, yet the remedies should be continued. The treatment 
must be general as well as local, or it will fail; for, no matter 
how skillful or scientific the local treatment may be, unless the 
constitutional condition be improved, the local affection will re- 
turn. The general hygienic directions advised under the head of 
scrofula 812) will be appropriate, together with the persistent 
use of my Golden Medical Discovery in proper doses. If the con- 
stitution be amende or broken down, some of the bitter tonics, as 
gentian 610), dogwood Oil), hydrastis (1" 613), or wafer-ash 
(®i 61V), with iron 618) alternated with the Discovery will give 
the best results. This method of treatment has cured hundreds 
of cases where the old method of relying entirely upon the local 
application of strong lotions has failed. DISEASES OP THE EYE. 
649 
Locally the treatment should be of an astringent character, 
for which make a tea of soft maple, bark of root, or a strong 
infusion of hydrastis 613) and witch-hazel leaves 518); two 
parts of the former to one of the latter, dropped into the eye, 
five or six times a day will produce good results. Cleanliness is 
absolutely necessary and the forehead and eyes should frequently 
be bathed with cold water. Dr. Sage’s Catarrh Remedy used 
weak is an excellent eye lotion. Nitrate of silver is recom- 
mended by some, but it must be used with caution, and the 
strength should not be more than that of one grain in three 
ounces of water. Blisters applied to the temples or to the back 
part of the neck are often employed in this affection, but I ques- 
tion their utility. In making local applications, the lotion should 
be put into the eye and not on the face, even if the child have to be 
forcibly held. When the disease shows no sign of improvement 
under this treatment there is evidently some fault that has been 
overlooked, and professional advice should be obtained. In 
consulting a physician, that one should be selected who makes 
diseases of the eye a specialty, for the eye is too delicate an 
organ to be tampered with, and not one doctor in a hundred 
understands its minute anatomy and pathology, and the proper 
treatment of its diseases. 
CASES TREATED. 
1376. Case I. This case, a fair sample of hundreds of 
similar ones treated at the World’s Dispensary, serves to illus- 
trate the success of mild means in overcoming this disease. 
Rosa B., aged six years, was brought to the Dispensary in 1869. 
She was scrofulous, and had been troubled with sore eyes nearly 
all her life. When I first saw her, she could not open her eyes, 
so great was the spasmodic contraction of the lids, and her hands 
involuntarily covered them from the light. She was feeble and 
delicate, though unusually bright and intelligent. On attempting 
to separate the lids there was a profuse discharge of hot tears; 
the eye was red, swollen and ulcerated at several points. 
Treatment. A liberal nourishing diet, outdoor air, exercise, 
bathing and other hygienic treatment was advised. The eyes 
were kept well cleansed with tepid water, and several times 
each day astringent lotions were applied to them, varied in com- 
position as the eyes improved. I directed her to wear a colored 650 
COMMON SENSE MEDICAL ADVISER. 
shade, in order to modify the intensity of the light, and to take 
the Golden Medical Discovery, with such tonics as her condition 
demanded. In two months she was so much improved that her 
mother returned home with her. Her eyes continued weak 
for some time, but by persevering in the same treatment, with 
the use of the compound lotion of golden seal and witch-hazel, 
she was restored to perfect health. 
CHRONIC INFLAMMATION OF TIIE EYES. 
1377. Whenever any form of acute inflammation of the eye 
passes into a chronic condition, more or less morbid changes 
occur in its external membranes. It is most frequently met with 
in persons who are debilitated or who suffer from constitutional 
contamination, and whose recuperative powers are low. The dis- 
ease is sometimes, however, produced by overtaxing the sight by 
reading fine print, or other work which strains the eyes, or em- 
ploying them closely by a strong or insufficient light. In this 
form, the disease may be sub-acute or chronic from the commence- 
ment, may come on slowly, or advance and recede alternately. 
(Chronic Conjunctivitis.) 
1378. Symptoms. The eye presents a vermilion red, or 
blood-shot appearance. The blood-vessels become enlarged, or 
tortuous, and may be seen to form a net-work, the color of which 
is deepest near the circumference, and spots of extravasated 
(discharged) blood may be seen in the membrane covering the 
eye. There is a sensation as if sand w’ere in the eye, there is 
intolerance of light, the lids are swollen, tears are discharged, 
a drop of matter may be seen in the corners, which varies 
from a mucous to a muco-purulent secretion. These symptoms 
may continue for months, or even year’s, according to the circum- 
stances of the patient. 
1379. Treatment. Until within a few years the treat- 
ment of this affection has been very unsatisfactory, simply 
because the eye was considered the only diseased part of the 
system, and consequently it was doctored and tortured, while the 
true nature of the disease was imperfectly understood and wholly 
overlooked in the treatment. 
1380. Correct treatment consists in improving the general 
health by every possible means. Any faulty condition of the DISEASES OP THE EYE. 
651 
system that may be present, as syphilis, debility, rheumatism, 
ansemia, scrofula, etc., must receive special attention and proper 
treatment. Strict attention to ventilation, exercise, bathing, 
diet, etc., are also of great importance. Keep the absorbents, 
as well as the secretions, active, by giving my Golden Medical 
Discovery and Purgative Pellets, and if the patient be robust, 
these remedies should be given in doses sufficient to produce a 
free action of the bowels. If, on the other hand, the patient be 
weak, feeble or debilitated, give the same remedies, but in less 
quantities, and alternate with tonics. If constitutional contami- 
nations, as scrofula and syphilis exist, use such treatment as I 
have advised for those diseases. 
Keep the eyes well cleansed by bathing them with Dr. Sage’s 
Catarrh Remedy, and use the astringent lotion of golden seal 
and witch-hazel, as advised under the head of Scrofulous Con- 
junctivitis. If to four ounces of this lotion, half a drachm of 
borax be added, it will be rendered more efficacious. Two grains 
of sulphate of zinc and one grain of morphine to an ounce of 
rose-water, make a good “ eye-water ” for this chronic affection. 
A solution of one grain of nitrate of silver and one grain of mor- 
phine, in one ounce of water, is also a proper application. Let 
it be remembered that whenever there is any ulceration, sugar 
of lead, as a local application, should never be used, for it will 
very likely produce opacity, by adhering to the parts and becom- 
ing oxidized. The lotions already advised are about the only 
ones that are safe in non-professional hands, but under the direc- 
tion of the qualified physician others may be employed to good 
advantage, to meet such conditions as are present in individual 
cases. The art of discrimination is essential to success in the 
treatment of this chronic malady, and can only be acquired by 
long study and wide experience. Hence the specialist very 
often succeeds in curing cases which prove intractable in the 
hands of the general practitioner; for although the latter may 
have an extensive general practice, he may not have as many 
cases of this disease in a whole year as the specialist has in a single 
day. 
CASES TREATED. 
1381. Case 1. Daniel W., aged 40, came to the World’s 
Dispensary in 1872. He was suffering from chronic conjunctivitis 652 
COMMON SENSE MEDICAL ADVISER. 
which for several years had resisted all treatment received from 
his home physician. Examination revealed increased redness of 
the conjunctiva, and the blood-vessels were enlarged and tortu- 
ous. Several ulcers existed, there was a considerable muco-puru- 
lent discharge, and his general health was very much impaired. 
Treatment. I directed him to thoroughly observe the rules of 
hygiene, and gave him suitable alteratives and tonics. The eyes 
wTere kept well cleansed, a mild tonic and astringent lotion was 
applied to them and the ulcers touched once a week with a pencil 
of sulphate of copper. At the end of one month he had so 
greatly improved that he was allowed to return to his home in 
Pennsylvania, and a continuance of the constitutional treatment 
for a month longer effected a perfect cure. This is but a fair 
representative of the numerous cases recorded at the Eye Depart- 
ment of the World’s Dispensary. 
GRANULAR LIDS. (Granular Conjunctivitis.) 
1382. Although this affection is usually spoken of as granular 
lids, yet it generally extends to that part of the conjunctival 
membrane which covers the globe of the eye, as may be seen by 
reference to Fig. 157. It can- 
not strictly be considered as a 
distinct form of conjunctivi- 
tis, as it is generally either a 
result or a concomitant of 
other forms, and is apt to 
occur if they be long-con- 
tinued. The granulations con- 
sist of enlarged papillae pro- 
jecting from the conjunctiva, 
and in the milder cases give 
to the inner surface of the lids 
a velvety appearance, but in 
the more aggravated forms a 
wrinkled, seamed or warty 
appearance. The disease at- 
tacks those generally of bro- 
ken-down or anaemic constitutions, or whose systems are depraved 
by previous disease. It prevails to a great extent among the 
Fig. 157. 
Granular Conjunctivitis. DISEASES OP THE EYE. 
653 
poor, or those subject to many privations, although it is not con- 
fined to this class. Granular lids are apt to be accompanied with 
a profuse secretion of tears, and sometimes pus (matter), which 
not unfrequently leads to ulceration and opacity of the cornea, 
as shown in Fig. 157. 
1383. Treatment. Considerable time is frequently neces- 
sary to effect a cure, and all measures will fail unless the general 
health be restored, the bodily functions improved and healthy 
materials elaborated to replace the diseased and worn-out tissues. 
Consequently all complications must be carefully considered, and 
such constitutional treatment adopted as the nature of the case 
demands. 
1384. The thickened condition of the conjunctiva must be 
removed by absorption, and to this end the processes of waste 
and nutrition should be kept active. This can be accomplished 
by the employment of my Golden Medical Discovery and Purga- 
tive Pellets, which may be combined or alternated with such 
remedies as may be indicated. Tonics are also generally required, 
together with a perfect observance of hygienic rules. If the 
patient be scrofulous, syphilitic, rheumatic or anaemic, the treat- 
ment recommended elsewhere in this volume for each of those 
affections will be appropriate in this case. 
1385. The necessary local applications cannot be well made 
except by the specialist who is prepared with proper instruments 
needful in treating diseases of the eye. Caustics are sometimes 
necessary and by some the knife is used to cut or scrape away 
the granulations. True, stimulating lotions may be made by the 
patient, but he will experience great difficulty in selecting the 
proper ones suited to his case. The knowledge and judgment 
necessary for such discrimination can only be acquired by expe- 
rience in the treatment of this disease. 
CASES TREATED. 
1386. Case I. Ezra P., aged 38, applied for treatment at 
the World’s Dispensary in 1873. He was first attacked with 
conjunctivitis which terminated in granulated lids. His consti- 
tution was feeble, and general health not very good. The 
Golden Medical Discovery and special tonics were prescribed. I 
applied the solid sulphate of copper by penciling the lids every 654 
COMMON SENSE MEDICAL ADVISER. 
third day for two weeks, after which I used it but once a week. 
At the end of the second month he returned home. His eyes, 
though weak, were free from inflammation, and his general 
health was better than it had been before in many years. He 
was directed to employ a weak infusion of witch-hazel or golden 
seal, and to wash the eyes once a day with Dr. Sage’s Catarrh 
Remedy, also to continue the use of the Discovery. A perfect 
cure was the result. 
1387. Case II. Nancy T., aged 34, came to the World’s 
Dispensary in 1873 to be treated for granular conjunctivitis. 
She being of a scrofulous diathesis, the constitutional treatment 
directed for scrofula in 812 was adopted, and stimulating 
astringent applications were made to the eyelids every third day. 
For some time the disease resisted this local treatment, but as 
her general health improved the disease abated. This continued 
until the cure was perfected. The treatment was continued, 
however, until the scrofulous manifestations subsided, and the 
functions of the body were all well established. 
INFLAMMATION OF THE CORNEA. 
1388. Inflammation of the cornea may he either acute or 
chronic, generally the latter. The cornea is commonly involved 
to some extent during the progress of inflammation of other 
structures of the eye, but I propose here to speak of uncompli- 
cated corneitis. This affection is usually of long duration, some- 
times continuing for months or even years, and is liable to result 
in ulceration, opacity, abscess, or staphyloma. Sometimes both 
eyes are involved at the same time, and it frequently happens that 
when but one is attacked, as that begins to improve the other 
becomes involved. Young children, and especially persons from 
ten to twenty years of age, are more liable to it, particularly 
those of a strumous habit; and also females at the age of puberty. 
As the disease progresses the whole cornea becomes red and vas- 
cular, resembling light-red cloth with a white spot in the centre, 
a condition that has been termed pannus; deposits of lymph also 
occur between the layers of the cornea, and the vision becomes 
obscured. The disease is apt to involve the iris, and if unsus- 
pected or neglected, closure of the pupil is liable to occur. 
(Corneitis. Keratitis.) DISEASES OF THE EYE. 
655 
1389. Causes. Constitutional derangement predisposes to 
inflammation of the cornea, as scrofula, syphilis, rheumatism, 
etc.; while the exciting causes are exposure to cold and wet, 
overexertion of the eyes, badly-ventilated abodes, insufficient 
food, injuries, irritating substances, corrosive eye-lotions, etc. 
1390. Symptoms. There is more or less pain in the eye, 
neuralgia of the orbit, increase of tears, intolerance of light, 
which symptoms are very intense in the acute form. The cornea 
becomes hazy, vascular and red. In the sclerotic coat 135), 
a belt of minute blood-vessels may be seen surrounding the 
cornea, which is an important diagnostic mark; in the edge of 
the cornea, a similar circle, or part of one, may be seen, composed 
of exceedingly minute vessels, while in the conjunctiva the vessels 
are large and tortuous. 
1391. Treatment. As the disease is prone to occur in 
persons of broken-down constitutions, scrofulous or syphilitic 
subjects, treatment appropriate to the constitutional condition 
must be instituted, and the most thorough regulation of the 
patient’s habits must be established. If the patient be plethoric, 
give a brisk cathartic. Sedatives, as aconite (*f 596), with a 
diaphoretic, as asclepias 550), wdll be beneficial, together with 
the spirit vapor-bath. Generally, all through the course of treat- 
ment, tonics, as well as alteratives are demanded, and the spirit 
vapor or the Turkish or Russian baths should be employed to 
keep the skin in good condition. We must improve the gen- 
eral health by every proper means, and to this end my Golden 
Medical Discovery and Pellets are advisable, in doses appropriate 
to the age of the patient. In some cases the value of the Dis- 
covery may be enhanced by the addition of half an ounce of 
iodide of potassium 468) or muriate of ammonia, to each bottle. 
This shovdd be alternated with the bitter vegetable tonics, iron, 
etc. Quinine and iron, in the form of pill or powder, should be 
used in preference to other tonics. 
1392. The eye needs rest, and must be protected from the 
light; indeed, the lids should not be separated, except for the 
purpose of making applications to it. The eye may be lightly 
covered by cloths wet in tepid water. The applications should 
be of a soothing or slightly stimulating character. Tincture or 
fluid extract of aconite leaves, one drachm to an ounce of water, 656 
COMMON SENSE MEDICAL ADVISER. 
is a valuable lotion to allay the inflammation, and may be 
dropped into the eye every two or three hours. After the first 
or more active stage of the disease, a weak solution of nitrate of 
silver or sulphate of zinc, one grain to the ounce of water; rose- 
water with ten grains of borax to the ounce; a weak infusion of 
golden seal, or the infusion of golden seal with a little borax 
added, are all valuable eye-lotions, suitable to be employed. 
One or two drops of a solution of atropia, two grains to the 
ounce, either separate or combined with one of the above men- 
tioned lotions, should not be overlooked. This will obviate 
the danger of permanent closure of the pupil in consequence 
of the adhesion of the iris to the cornea, a result quite likely 
to occur if such precaution be not taken. The disease is one 
that requires great skill for its successful management, and no 
non-professional person should attempt its treatment. Indeed, 
few physicians will be likely to assume its management, unless 
they are ignorant of the deplorable results (hereafter mentioned) 
which are liable to follow its improper treatment. 
1393. Opacities of the cornea result from inflammation of 
the conjunctiva, or cornea, or in consequence of injuries to the 
cornea. These opacities, more or less obscure the vision, accord- 
ing to their situation, extent and thickness. They are divided 
according to their situation in the layers of the cornea, into super- 
ficial, central and deep. When they are moderate in size, quite 
superficial and thin, looking like a faint grayish blue cloud, they 
are called nebulae,' when the opacity is greater, denser, pearly 
white and situated deeper in the substance of the cornea they 
are termed albugo; when there is a corneal or eorneo-conjunc- 
tival scar or cicatrix extending deep within the structure of the 
cornea, resulting from a loss of substance, and its edge well de- 
fined, it is termed leucoma. The nebulous variety is apt to 
result from inflammation of the conjunctiva, and is much more 
easily managed than the other varieties which generally result 
from inflammation or injuries. Formerly when lotions of sugar 
of lead were oftener used than at present, these opacities were 
much more common, as a direct result of the oxidation of the lead 
and its deposition in, and adhesion to, the coats of the cornea. 
OPACITIES OF THE CORNEA. DISEASES OF THE EYE. 
657 
1394. Treatment. The younger the patient, the more 
readily will the opacity yield to the treatment. It is sometimes 
astonishing with what rapidity the part affected is restored in 
children. The form teiuned leucoma is the most persistent of 
any, and it may be doubted if medical treatment ever does effect 
a perfect cure, though time and appropriate medicines may 
greatly narrow the extent of the opacity. The treatment 
mostly relied upon at the World’s Dispensary consists in enjoin- 
ing a thorough observance of hygienic regulations and the 
administration of such internal remedies as the condition of the 
constitution demands. Prominent among the remedies I prescribe 
are alteratives and tonics; I also recommend a good and nourish- 
ing diet. The absorbents are to be kept continually active by 
the use of my Golden Medical Discovery. To each bottle add 
one-half ounce of iodide of potassium. My Purgative Pellets 
should be used to keep the contents of the bowels in a soluble 
condition. 
Locally, all kinds of stimulating lotions have been employed 
by experimentalists, and nearly every known irritant has been 
tried, not even omitting croton-oil and mercurial ointment. To 
use such agents is unphilosophical and hazardous in the extreme. 
Pure sweet-oil, or melted lard, are far superior agents. Various 
ointments are useful, as fifteen grains of powdered borax in an 
ounce of lard; or five grains of iodide of potassium in an ounce 
of lard or fresh butter. The cautious application of diluted 
tincture of cayenne pepper with a camel’s hair pencil, is often 
useful. More powerful irritants than those already advised, 
should never be used except by a skillful oculist, for, instead of 
removing the opacity they may cause destructive inflammation. 
A lotion of one grain of atropia to an ounce of water, applied 
twice a day, must not be overlooked. When all medicines fail, 
which is sometimes the case in leucoma, or if chalky deposits 
take place in the cornea, an operation for providing an artificial 
pupil, illustrated in Fig. 159, may be skillfully performed, and at 
once restore the vision. 
ULCERATION OF THE CORNEA. 
1395. Ulceration of the cornea may be caused by purulent, 
or scrofulous inflammation, injuries, disease of the nerves which 658 
COMMON SENSE MEDICAL ADVISER. 
supply the cornea, great debility of the general system, or by 
anything that results in defective nutrition of the eye. Corneal 
ulcers may be superficial or deep-seated, the latter being most 
troublesome and dangerous, and when located at the centre of 
the cornea are more liable to interfere with vision than when 
situated near its circumference. There may be one or several, or 
one may follow another. They may sometimes be so small as 
scarcely to be seen, but are nevertheless dangerous. They are 
generally accompanied with more or less inflammation, which 
varies according to the character of the ulcer, of which there 
are several varieties. They may perforate the cornea and thus 
destroy the vision. 
1396. Symptoms. There is a sensation as if there were 
dirt or grains of sand in the eye, accompanied by more or less 
redness, and straggling conjunctival blood-vessels may be ob- 
served running toward the cornea; there is increased secretion 
of tears and intolerance of light, and a careful examination of 
the eye will reveal a little depression on the surface of the 
cornea. 
1397. Treatment. The treatment of ulcers must always 
be according to the cause which gave rise to them. Attention to 
the general health is necessary, as in the majority of cases it is 
considerably impaired, and the system so much below par that 
the natural reparative processes cannot go on. Tonics with 
alteratives are required, also good diet and rest are necessary. 
Give the Golden Medical Discovery, in medium doses, with iron 
and hydrastin. If there be syphilis, employ the treatment sug- 
gested under that head. If inflammation exists it must be over- 
come. Apply, locally, an astringent lotion, as the infusion of 
gold thread 616), or the golden seal and wdtch-hazel decoction 
already alluded to; or ten grains of borax in an ounce of infusion 
of golden seal, or one grain of nitrate of silver in an ounce of 
rose-water. If the disease does not promptly yield, a competent 
oculist should be consulted. 
STAPHYLOMA. 
1398. Staphyloma is an affection of the eyeball and is char- 
acterized by the protuberance of the cornea which loses its 
transparency and becomes a bluish white, or pearl color, Fig. DISEASES OF THE EYE. 
659 
158. The sclerotic coat (1 135) is also sometimes involved. 
In some cases the pain is intense, in others slight. 
1399. Staphyloma may be partial or 
total. In the first case the projection is 
comparatively slight, in the second it is 
very large, frequently rough and uneven 
and the sight wholly destroyed. 
1400. Causes. Ulcers, injuries, ab- 
scesses and sloughing may all be causes 
of this affection. 
1401. Treatment. The treatment 
must necessarily be chiefly local and con- 
sists in a removal of the tumor. If the affection be partial, 
the operation should be performed as early as possible, for the 
purpose of arresting its progress and thus preserving the re- 
maining sight. If it be total, the unsightly, morbid growth 
should be removed, or the sound eye will be quite liable to 
become sympathetically diseased. Numerous cases have come 
to my notice in which staphyloma of one eye, through sympathy 
lias produced inflammation in the other, and when the tumor, 
from the diseased eye was removed, the other was restored. 
Fig. 158. 
Staphyloma. 
1402. If staphyloma be accompanied by some constitutional 
affection, those remedies should be employed which are suited to 
each individual case. 
INFLAMMATION OF THE IRIS* (Iritis.) 
1403. This affection, also known as Internal Ophthalmia, 
may be considered under two forms, viz., acute and chronic. 
1404. The acute form does not occur as frequently as the 
chronic, is more rapid in its course, and when improperly treated, 
often results in other diseases of the eye, or the chronic form of 
this affection. 
1405. Symptoms. There is at first dimness of vision, 
and the color of the eye is changed: if naturally hazel, it be- 
comes a dark red; if blue or gray, it is changed to a greenish 
color. The lining membrane of the eyeball and lids has a 
pinkish appearance. There is a burning, stinging pain, a profusion 
* For anatomy of the iris, see If 135. 660 
COMMON SENSE MEDICAL ADVISER. 
of tears, and it is with the greatest difficulty that the patient 
can open his eye. The pain is paroxysmal, and generally occurs 
in the night-time. This affection is usually attended with con- 
siderable fever, the tongue is coated, the skin dry, the pulse 
quick and hard, the bowels are constipated, there is headache, 
thirst, restlessness, and, as the disease progresses, the eye has a 
hazy appearance. 
1406. Causes. It may be produced by wounds or injuries 
of any kind, and is then termed traumatic, or it may be the 
result of cold, or use of the eye, when it is known as 
rheumatic inflammation. 
1407. Treatment. An emetic should be taken, after 
which a spirit vapor-bath may be used. As a revulsive measure 
a hot mustard foot-bath is recommended. Small doses of my 
Compound Extract of Smart-Weed, in some diaphoretic infusion, 
should also be given. To keep the bowels regular, an active 
cathartic should be administered as often as the case requires. 
The circulation may be controlled by veratrum 597). If, 
however, the patient be debilitated or ansemic, this treatment 
should be materially modified. As soon as there is a remission 
of the symptoms, two or three grains of quinine, with one of my 
Purgative Pellets, should be given every three or four hours. 
My Golden Medical Discovery, taken internally, will, by its 
alterative properties, favor the absorption of any lymph that 
may have been deposited in the eye during the progress of the 
inflammation. 
1408. If the disease be of the rheumatic form, in addition to 
the above treatment an alkaline diuretic, as acetate of potash 
569), or saltpetre 568), is advised. If the pain be very 
severe, some anodyne, as hyoscyamus 481), may be used. 
1409. The eye should be excluded from the light, and fre- 
quently bathed with warm soft water. A solution made from 
two gi-ains of atropia 483) and one ounce of water, dropped 
into the eye two or three times a day, is of great benefit. A 
lotion of the tincture of aconite leaves may also be used several 
times a day. Should the above treatment fail in effecting a cure, 
a skillful physician should at once be called. 
1410. Chronic*inflammation of the iris more frequently 
,’cours than the acute form, and may be severe at first, or its DISEASES OE THE EYE. 
661 
approach may be so gradual that it is unnoticed until indistinct- 
ness of vision indicates the diseased condition of the eye. 
1411. Symptoms. These are essentially the same as in 
the acute form, although much milder in character. There is a 
dull pain in the eye, attended with a sensation of weakness. 
The pupil is smaller than natural and contracts and dilates 
slowly. The brightness of the eye is faded, and a belt of blood- 
vessels may be seen around the cornea; the vision gradually be- 
comes indistinct and is finally entirely lost. 
1412. Caiise§. It may be the result of the acute form, or 
of prolonged inflammation of some other part of the eye. It 
may also be caused by other diseases. Scrofula frequently in- 
duces this inflammation, in which case yellowish spots occasioned 
by the effusion of lymph may be seen here and there upon the 
iris, and the cornea is sometimes mottled and opaque. It may 
also follow from venereal disease, when it is known as syphilitic 
inflammation of the iris, a representation of which may be seen 
in Fig. 31, Colored Plate No. Y. 
1413. Treatment. In this form the treatment must be 
energetic. Hygienic conditions should be observed, and every 
third or fourth day a spirit vapor-bath should be employed. My 
Pleasant Purgative Pellets, alternated with tonics, as iron (!"618), 
quinine (*f496), hydrastin (*[613), dogwood or nux vom- 
ica should be taken in sufficient doses to keep the bowels 
regular. Warm poultices should never be applied to the eye, 
since they favor suppuration and are liable to destroy the sight. 
The atropia lotion, advised in the treatment of the acute form, 
should be used in this. The local treatment for the scrofulous 
form should be similar, but the constitutional treatment must be 
adapted to the condition of the system. The same is true of 
the syphilitic form. A green shade for the will be of ser- 
vice. Other parts of the eye are liable to be implicated in this 
inflammation, hence the ophthalmoscope should be employed to 
detect the first approach of disease. 
CASES TREATED. 
1414. Case I. In 1872, Richard P., of Canada, aged 29, 
applied at the World’s Dispensary for the relief of chronic iritis. 
He had suffered about three months, and his general health was 662 
COMMON SENSE MEDICAL ADVISER. 
considerably deranged. The iris was contracted, of a muddy 
color, and effusions of lymph were visible upon it. I advised a 
nourishing diet, gave him alteratives and tonics suited to his case, 
made local applications to produce dilation of the pupil and allay 
the inflammation, and protected the eye from the light with a 
green shade. In two months his general health was much im- 
proved, the lymph absorbed, and aside from his eye being a little 
weak (which sensation was finally removed by an infusion of 
liydrastin and the use of the Discovery), he was fully restored. 
1415. Case II. In 1874, George B., aged 20, consulted 
me for the treatment of iritis, which was rapidly progressing. 
The iris was of a muddy color, and a peculiar angular deformity 
existed. I learned upon inquiry that about eight months pre- 
vious he contracted syphilis and had been treated with mercury 
and iodine for that disease, but without benefit. I at once com- 
menced treatment for constitutional syphilis. Atropia was 
applied locally, together with fomentations. At the end of a 
month there was a decided improvement, and in two months all 
traces of iritis had vanished, and after further treatment for 
syphilis, he was completely restored to health. 
CLOSURE OF THE PUPIL. (Atresia Pupillaris.) 
1416. Closure of the pupil is characterized by a total loss of 
sight, and is the result of in- 
flammation of the iris. 
1417. Treatment. If 
there be any constitutional 
derangement, it should be rec- 
tified by remedies suited to 
the case. In this disease solu- 
tions and lotions applied to 
the eye are of no benefit, and 
surgery promises the only re- 
lief. If the disease does not 
extend behind the iris, the sur- 
gical operation termed iridec- 
tomy (Fig. 159) will speedily 
restore the sight. It is need- 
less to add that such a delicate operation requires a perfect 
Fig. 159. 
Iridcctomy. DISEASES OF THE EYE. 
663 
knowledge of the anatomy of the eye, as well as familiarity with 
the proper insti’uments with which to perform it. The Eye 
Department of the World’s Dispensary is furnished with all the 
surgical instruments required for operations upon the eye, and at 
its head is a competent surgeon prepared to skillfully treat this 
class of diseases. 
GLAUCOMA. 
1418. From the earliest history of medicine great differences 
of opinion have prevailed with regard to the pathology of this 
disease. Formerly the term glaucoma was indiscriminately ap- 
plied to all diseases affecting that part of the eye behind the 
pupil. Some regarded it as an inflammatory affection of the 
iris and choroid others thought that it was a disease of 
the retina, or vitreous humor, while others again claimed it to be 
due to some change in the refracting power of the lens. Not 
until the invention of the ophthalmoscope was the real nature of 
the disease understood. Mackenzie remarks, “Glaucoma com- 
prehends a series of morbid changes, which in general develops 
itself only in the course of years, to involve, at last, all the 
structures of the eye.” The disease may be either acute or 
chronic. If the acute form be present it progresses rapidly and 
generally affects both eyes at the same time. The chronic form 
is most frequent and years may elapse before the structures be- 
come so involved as to destroy the sight. 
1419. Symptoms. The eye presents a greenish appear- 
ance, varying from a slight discoloration to a light green color. 
In the acute form, the symptoms sometimes appear very rapidly, 
and the vision becomes extinct after a few hours of terrible pain. 
At other times the disease is gradually developed. There is a sen- 
sation as if sparks, flames, balls of fire, or bright colors, were 
passing before the eyes. The conjunctiva becomes red and the 
pupil dilated. Pains shoot from the eyes to the forehead and 
temples, the iris becomes dull, the eyeballs hax*den, the cornea is 
less prominent, water flows from the eyes, there is dimness of 
vision, and, finally, the sight is altogether lost. 
In the chronic form, there is pain and dimness of vision, which 
occur at intervals, becoming more and more frequent, until these 
symptoms are continually present. Nearly all the symptoms of 
the acute form are present in this, and may continue for months, 664 
COMMON SENSE MEDICAL ADVISER. 
and sometimes years, the sight gradually becoming impaired, 
until it is finally lost. 
1420. Treatment. In the acute form, anodynes should 
be given, to relieve the pain. The bowels, skin and kidneys, 
should be kept in a healthy condition. The eyes must be kept 
in a state of rest, and a solution of atropia applied to them once or 
twice a day. On account of the rapidity with which this disease 
progresses, a skillful physician should at once be called. 
In the chronic form, the general health must be improved. 
Hygienic treatment should be observed, together with the use of 
alteratives and tonics. My Golden Medical Discovery should be 
taken in large doses. If the pain be severe, anodynes should be 
employed. The spirit vapor-bath once or twice a week is also 
beneficial. In both the acute and chronic forms, a surgical 
operation is necessary, and should be performed as early as pos- 
sible, before the sight is completely destroyed. If the operation 
be delayed until disorganization of the eye has taken place, treat- 
ment is liable to prove useless; whereas if it be performed in the 
earlier stages, the disease may be arrested and the sight pre- 
served. Iridectomy is the operation usually adopted at the 
World’s Dispensary (see Fig. 159), and is the one advised by 
Von Graefe, a celebrated German oculist, who has given the 
subject much attention. It is also recommended by other emi- 
nent oculists. 
AMAUROSIS. (Impaired Vision.) 
1421. The term amaurosis signifies a loss or decay of sight. 
This impairment of vision is due to some change in the retina, 
optic nerve, or brain, and may be either partial or complete, 
functional or organic. There may be said to be three stages of 
this affection: (1.) The eyes are weak, with but little diminu- 
tion of sight; (2.) The loss of sight is more marked; (3.) The 
sight is entirely lost. 
1422. Causes. Various causes favor the establishment of 
amaurosis. It is common to the young as well as the old, and 
most frequently occurs to those of a nervous temperament. It 
may be due to congestion of the retina, exposure to intense light, 
excessive use of the eyes, assiduously applying them to the lens 
or microscope, or the use of improperly adjusted glasses. It may DISEASES OF THE EYE. 
665 
be the result of an exhausted condition of the nervous system, 
of excessive study, hemorrhages, venereal excesses, masturba- 
tion, spermatorrhoea, exhaustive diarrhoea, intemperance, cholera, 
fevers, hysteria, convulsions, sunstroke, derangement of the 
stomach, suppression of habitual discharges, use of tobacco, etc. 
1423. Symptoms. The eye is at first w'eak, which indi- 
cates that it must be shaded; it is red and painful, the pupil is 
dilated and does not readily contract, and there is a mist or blur 
continually before it. The sight becomes impaired, and there is 
a sensation as if minute objects were continually passing before 
the eyes, and one color cannot be distinguished from another. 
The gait becomes uncertain, and the patient gropes his way along 
as if in the dark. As the disease progresses the vision becomes 
more and more impaired, and total blindness is the final result. 
1424. Amaurosis is apt to be confounded with glaucoma or 
cataract. It may be distinguished from glaucoma, which is char- 
acterized by hardness of the eyeball and green color of the eye. 
In amaurosis the pupil is of its natural color, whereas in cataract, 
Fig. 160. 
Employment of the Ophthalmoscope. 
an opaque body appears behind it. To the person affected with 
amaurosis objects appear discolored or perverted in shape, and 
seem to float before the eye; in cataract the vision is clouded but 666 
COMMON SENSE MEDICAL ADVISER. 
objects do not float before the sight. If amaurosis be complete, 
the patient cannot distinguish between light and darkness,while 
in cataract he is sensible to both. By the ophthalmoscope, as 
represented in Fig. 160, amaurosis may be distinguished from 
other affections of the interior of the eye. This instrument is of 
inestimable value to the specialist in determining the nature of 
the disease, for by understanding the conditions which are made 
apparent, the treatment is much more direct and certain. 
1425. Treatment. In amaurosis, the causes of the affec- 
tion should be well understood, since only constitutional treatment 
can be advised. If the disease be inflammatory, or the patient 
be plethoric and has headache, giddiness, red face, hot skin, full, 
quick pulse, apparent flashes of light, or balls of fire passing be- 
fore the eyes, the treatment must be vigorous. The spirit vapor- 
bath and hot mustard foot-bath should be given daily. Aconite 
and belladonna, together with my Extract of Smart-Weed, 
should be taken in suitable doses, and some purgative, as Epsom 
salts 541). As soon as there is a remission of the symptoms, 
my Golden Medical Discovery and Purgative Pellets may be 
taken. 
1426. If amaurosis be caused by an enfeebled condition of 
the nervous system, and there is general debility, quick pulse and 
anaemia, then tonics and nervines are indicated, together with a 
nourishing diet and other hygienic agencies. Small doses of my 
Purgative Pellets, to keep the bowels regular, may also be 
given. 
If the blindness be sympathetic and result from some other 
disease, the general system must be toned, and treatment be 
given according to the nature of the affection. 
If the affection be organic, tonics, nervines and other agents 
are advised to suit the case; my Golden Medical Discovery and 
Purgative Pellets are generally found useful in nearly all 
forms of amaurosis. This disease is often improperly treated, on 
account of the causes which produce it and the conditions which 
favor it, not being understood. I have restored hundreds in a 
short time by carefully diagnosing each case, and varying the 
treatment so as to adapt it to the condition and constitution of 
the different patients, and also to the causes in which the 
affection had its origin. DISEASES OP THE EYE. 
667 
1427. The term cataract, when applied to the eye, signifies 
an opacity of the crystalline lens, 135), or its capsule, or both; 
the passage of the rays of light is thereby prevented and vision 
precluded. When the ojmcity is confined to the lens it is termed 
lenticular/ when to the capsule it is called capsular; when to 
both the lens and capsule it is known as capsulo-lenticular 
opacity. Cataracts may be divided into hard and soft, and may 
occur at any age and involve one or both eyes. It makes its 
appearance gradually; at first objects are indistinctly seen, as 
through a mist, and the vision becomes more and more indistinct 
as the opacity increases, until the person becomes entirely blind. 
CATARACT. 
1428. Canses. The true cause of this disease is yet a sub- 
ject of discussion among ophthalmologists. Persons of feeble or 
broken-down constitutions are most subject to it, doubtless 
owing to the impairment of the nutritive functions. 
1429. 8yill])tOlUS. The affection is painless; there is no 
intolerance of light or flow of tears, and were it not for the 
gradual loss of sight, the patient would not be aware of the dis- 
ease. There is at first dimness of vision, and a mist or cloud 
appears-before the eyes. This condition is more marked in a 
bright day, and objects can be seen more distinctly if placed at 
one side than if directly in front of the eye. Upon examination 
an opaque body is observed behind the pupil. The pupil itself is 
natural in appearance and dilates or contracts readily when 
exposed to the light. 
1430. Cataract may readily be distinguished from opacities 
of the cornea by remembering that, in the latter affection, the 
opacities are in front of the pupil, while in cataract they are be- 
hind it. It is sometimes confounded with glaucoma and amau- 
rosis, but can readily be distinguished from those diseases, for in 
cataract the sight is best in cloudy weather, or in a subdued 
light; there is no pain in the eye or head, nor is there any con- 
stitutional disturbance; the sight is seldom entirely obliterated, 
but the patient can distinguish between daylight and darkness, 
and the eyeball preserves its natural consistence. 
1431. Treatment. Until very recently surgical treatment 
was regarded as the only means by which cataract could be 668 
COMMON SENSE MEDICAL ADVISER. 
relieved. Eminent oculists now entertain the idea that in some 
cases medical treatment is beneficial. Dr. King says: “There 
are three conditions presented to the practitioner, viz: first, the 
cataract may be just commencing; second, it may be almost 
complete or fully matured without serious complications; or, 
third, the cataract may be complete or incomplete with serious 
complications.” In the first condition medical treatment may 
be successful and should consist of a thorough alterative course. 
My Golden Medical Discovery with iodide of potassium or the 
muriate of ammonia, are recommended. In the second and third 
conditions relief can only be expected by a surgical operation. 
1432. Ihe methods of operating may be classified under three 
general heads, viz: Division or Absorption, Depression or Dis- 
placement, and Extraction. By the first method, a needle is 
passed through the sclerotic (see Fig. 
161) and the opaque lens, and its 
capsule broken into fragments, which 
by dextrous manipulations are pushed 
forward into the anterior chamber of 
the eye (*[[ 135), where they are acted 
upon by the aqueous humor, and 
The pu- 
pil, in the figure, 
appears fully dilated and larger than 
the cataract, which occupies the cen- 
tre and is represented by the white 
spot. This operation is most suc- 
cessful in soft cataract, and is accom- 
panied with but little escape of the 
aqueous humor. 
1433. By the second method, the needle is passed through 
the coats of the eye, pushed carefully forward in front of the 
cataract (the pupil having previously been dilated), and applied 
to the upper and front part of the lens. It is then pressed down- 
ward and backward into the vitreous humor. The needle is re- 
tained for a few moments in the eye, until it is ascertained if the 
lens is disposed to rise; if so, it is again depressed; if not, the 
needle is withdrawn. This operation is not very successful, as 
it is liable to be followed by inflammation. 
Fig. 161. 
Operation ior Cataract, by Division. DISEASES OF THE EYE. 
669 
1434. By the third metho'd—extraction—the lens is entirely 
removed. This operation is more delicate than either of the 
others, and it is also more successful. There are various ways of 
performing this operation. The one known as the linear method 
of extraction is accomplished by making an incision through the 
cornea, near the sclerotic, on the outer side of the eye; upon 
withdrawing the knife, the aqueous humor escapes. A curved 
needle is now introduced, and the capsule cut, when the lens 
readily escapes by pressure upon the opposite side of the eye. 
It is a prevalent opinion that any escape of the aqueous humor 
will result in loss of vision. This impression is erroneous, for in 
many operations upon the eye, this fluid is permitted to escape. 
Whenever the aqueous humor is evacuated, it is again produced 
in from twenty to thirty hours. 
1435. By thefiap operation of extraction, as shown in Fig. 162, 
and made by what is termed 
the “lower section,”—an in- 
cision is made in the cornea 
near the sclerotic, as repre- 
sented in the figure, and the 
cornea is divided. The cap- 
sule is then cut and the lens 
allowed to escape. In the 
figure the lens is represented 
as escaping from the incision 
made in the cornea. After 
the operation is completed 
the eyes are kept closed by 
strips of adhesive plaster, 
which should be removed 
every day to ascertain the condition of the eye. The patient 
should be kept in a darkened room and in a recumbent position, 
for some time, and care be taken that he does not disturb the eye 
during sleep. The wound in the cornea speedily heals by what 
is known as first intention. 
Fig. 162. 
Flap operation for Cataract. 
1436. The modified linear method of extraction,represented by 
Fig. 163, is a modification of both the linear and flap operations, 
and may be divided into (1) incision, (2) iridectomy, (3) opening 
the capsule, and (4) extraction of the lens. In Fig. 163, the COMMON SENSE MEDICAL ADVISER. 
eye is represented as transfixed with a knife and held by fixation 
forceps. The knife is then moved upward, following the scle- 
rotic until a complete flap is cut; iridectomy is then performed, 
the capsule opened and the 
lens extracted in a manner 
similar to the preceding oper- 
ation. 
1437. After any operation 
for cataract has been per- 
formed, the patient should 
have the best of care, for 
through ignorance, careless- 
ness or neglect, serious con- 
sequences may ensue. To 
meet this necessity I have 
made suitable provision 
whereby every patient upon 
whom I operate shall have 
every attention after the operation until the cure is complete, 
and he can with safety return to his home. 
Fig. 163. 
Modified linear method of Extraction. 
PTERYGIUM. 
1438. The word Pterygium—from its Greek derivation sig- 
nifying a wing—is applied to a disease of the eye. The affection 
is characterized by a vascular thick- 
ening of a portion of the conjunc- 
tiva which is triangular in shape 
and bears a resemblance to the 
wing of an insect. This thickened 
membrane usually occupies the 
nasal side of the eye, its base be- 
ing situated at the inner corner 
and its apex directed to the cornea, 
thereby obstructing the sight, as 
illustrated by Fig. 164. Some- 
times one of these membranes is 
formed on the inner and one on the 
outer side simultaneously, in which case they may entirely cover 
the cornea. In the early period of the disease this membrane is 
Fig. 16Jf. 
Pterygium. DISEASES OF THE EYE. 
671 
thin and light-colored and causes but little if any disfigurement, 
but later it becomes inflamed and eventually destroys the sight. 
1439. Causes. These are obscure, but inflammation or 
continued irritation favors the production of this disease; it 
most frequently occurs in warm climates. 
1440. Treatment. The absorbents should be kept active 
by the use of my Golden Medical Discovery and Purgative Pel- 
lets, which for this purpose are unequaled. Local applications 
may be employed, but with great care. Caustics or the tincture 
of capsicum may be applied to the pterygium, but they are very 
painful, and unless used with caution will be productive of much 
harm. A solution made from three grains of sulphate of 
copper and one ounce of water, may be applied two or three 
times a day. If the growth be large, or if the means above 
advised fail, it should be removed by a surgical operation. Both 
medical and surgical treatment are employed at the World’s 
Dispensary, according to the nature of the case, the latter only 
being resorted to when the former fails to perfect a cure. 
FOREIGN BODIES IN THE EYE. 
1441. The eye is liable to injury from the introduction of 
foreign bodies, which occasion suffering and inflammation, if 
allowed to remain. These substances may be cinders, glass, 
scales of iron, particles of sand, bits of wood, lime or mortar, 
gunpowder, and sometimes pieces of percussion-caps, insects, etc. 
When very small, they may be washed away by tears, but they 
are liable to become imbedded in the structures of the eye, or 
lodged in the conjunctiva, where they remain until they produce 
congestion or inflammation, which is very much intensified by 
rubbing the irritated organ. 
1442. Treatment. This consists in removing the parti- 
cles from the eye. Let the patient be placed in a good light, 
and his lids drawn apart by a person standing behind him; if the 
eye be then rolled in every direction, the particles may generally 
be seen, and removed with a pointed instrument. If the sub- 
stance be lodged beneath the upper lid, by turning the lid out- 
ward it may be removed by a pencil or probe. If the substance 
be lodged directly in front of the pupil, especially if the eye be 
black, it is very liable to be overlooked, but it may usually be COMMON SENSE MEDICAL ADVISER. 
discovered by looking across the eye, and is best removed by the 
point of a lancet. If the substance has passed beneath the layers 
of the cornea, it may be removed by making an incision, and 
lifting it out with a pointed instrument. A magnet is often 
efficient in extracting bits of iron from the eye. Lime should be 
removed as quickly as possible, and the eye syringed with a weak 
solution of tepid water and vinegar. Glycerine or pure water 
may be used, if vinegar is not at hand. If the foreign substance 
be acid, the neutralizing agent should be alkaline, and a solution 
of salaeratus or soda is generally beneficial. Pitch is best re- 
moved with oil. If there be gunpowder in the eye, it should be 
picked out as soon as possible, or the nitre will dissolve and give 
rise to extreme pain, inflammation and discoloration of the eye. 
Pieces of percussion-caps should be removed as quickly as pos- 
sible by a surgeon. After any substance has been removed, the 
eye should be bathed with tepid water, milk and water, or rose- 
water, or a weak decoction of tea, after which the eye should be 
protected from the light. 
CROSS-EYE. (Strabismus.) 
1443. This is an affection in which the axes of the eyes can- 
not be directed the same way and therefore when one eye is 
turned toward, the other is turned away from the object. Stra- 
bismus may be divided into convergent, when the eye is turned 
toward the nose, divergent, when turned away from the nose and 
oblique when it is directed obliquely upward or downward. 
1444. Causes. This affection may be congenital, but it is 
frequently induced by some disease of childhood, as whooping- 
cough, measles, worms, etc., or by irritation of the stomach, 
constipation, fright, or passion. It may be produced by an 
enfeebled condition of the nervous system, diseases of the brain, 
opacity of the cornea, by using one eye to the entire exclusion 
of the other, or by sportively attempting to imitate cross-eyed 
people. 
1445. Although it is easy to detect this affliction in a person, 
it is not always easy to determine which eye is turned. “ In 
order to ascertain which is the squinting eye, the patient should 
be directed to look steadily at an object (a lighted candle 
or uplifted finger), held in the horizontal median line, at the DISEASES OP THE EYE. 
distance of a few foet from the face. Then alternately cover- 
ing each eye with the hand, note whether the uncovered eye 
remains steadily fixed upon the object or has to change its posi- 
tion before it can bring its visual line to bear upon it.”—Wells. 
There are various other methods employed to discover which is 
the affected eye. 
1446. Treatment. If strabismus be produced by dis- 
ease of the brain, such remedies must be employed as will ben- 
efit that affection. If due to an enfeebled condition of the 
nervous system, tonics, alteratives and nervines should be em- 
ployed. If to convulsions, antispasmodics 507) and nervines 
589) are indicated. Some exercise of the crooked eye may 
be beneficial; for example, shut the well eye and, keeping the 
head in one position, let the affected member be directed toward 
a glass and then suddenly open the other. The repetition of this 
experiment has sometimes been serviceable in restoring the 
affected eye. 
When other means fail, a surgical operation will completely 
obviate the difficulty. The operation may be performed quickly, 
and with very little pain. Fig. 165 repre- 
sents an operation performed on convergent 
cross-eye. It consists in making an incision 
in the sclerotic, and raising the contracted 
muscles writh a blunt hook, and passing one 
blade of the scissors beneath the muscles, 
which are then divided, and the eye is made 
straight. 
Physicians in ordinary prac 
tice seldom have occasion to treat these af- 
fections, and are therefore not proficient in 
operating and generally direct the patient 
to some skillful surgeon. Consequently, at 
the World’s Dispensary there are many 
cases of this character treated, and I have 
devoted especial attention to these affections, 
and am provided with every thing necessary 
to effect the most approved and successful 
operations. 
Fig. 165. 674 
COMMON SENSE MEDICAL ADVISER. 
OBSTRUCTION OF THE LACHRYMO-NASAL TUBE, 
OR TEAR-DUCT. 
1447. The lachrymo-nasal tube—the passage which conveys 
tears from the eye to the nose—is liable to be obstructed, and 
hence the tears, deprived of their usual exit, flow outward over 
the cheek. The person is then said to have watery eyes. If the 
passage be entirely closed, the amount of tears will be greater 
than if only partially obstructed, and the nostril on the affected 
side will be correspondingly dry. If the duct be obstructed 
below the lachrymal sac, the tears will accumulate and produce 
swelling, inflammation or abscess. 
1448. C<IUS6S. The obstruction may be due to inflamma- 
tion of the lachrymal sac or adjacent structures, and most fre- 
quently occurs in persons of a scrofulous diathesis. It may be 
caused by nasal catarrh, which produces a thickening of the 
mucous membrane lining the duct. Again, the tears may not 
enter the sac, in consequence of the small canals which convey 
them from the lids to the lachrymo-nasal tube being obstructed. 
1449. Treatment. If the affection be the result of 
scrofula, corresponding constitutional treatment is advised, if 
due to catarrh, the use of my Golden Medical Discovery, to- 
gether with Dr. Sage’s Catarrh Remedy, applied with the Nasal 
Douche, is recommended; if to obliteration of the canaliculi 
(little canals), a surgical operation is necessary. If there be 
stricture of the duct, a probe should be passed through it into 
the nasal cavity, and the operation repeated by changing from a 
small to a large instrument. 
LACHRYMAL FISTULA. 
1450. Whenever there is continued inflammation of the lach- 
rymal sac, it produces an abscess or 
fistula which discharges its contents 
upon the cheek through the skin, a 
little below the inner corner of the eye. 
A representation of lachrymal' fistula 
may be seen in Fig. 166. 
1451. Treatment. This con. 
sists in removing the obstructions of 
the duct by passing through it a long slim knife and keeping the 
Fig. 166. 
Lachrymal Fistula. DISEASES OP THE EYE. 
675 
passage open by the frequent introduction of probes, or by the 
insertion of a little silver instrument called a style, which is worn 
in the passage until all danger of its contracting and closing 
again is passed. 
INFLAMMATION OF THE LIDS. (Ophthalmia Tarsi.) 
1452. Inflammation chiefly affects the edges of the eyelids, 
although it may extend to the conjunctiva. It is generally 
chronic and is liable to cause more or less disfigurement. 
1453. CilllSCS. It may be caused by exposure to the 
atmosphere, dirt, irritating vapors, inflammation of the eye, un- 
cleanliness, etc., or it may be due to catarrhal or purulent 
conjunctivitis, intemperance, unwholesome food, excessive use of 
the eyes by artificial light. It is most frequent in persons of a 
feeble constitution or scrofulous diathesis; soldiers, farmers 
and travelers are also subject to this affection. 
1454. Symptoms. The edges of the eyelids are red, 
swollen and covered with a secretion from the glands of the lids; 
there is an itching, burning sensation, and they adhere to each 
other in the morning. If produced by scrofula, the incrustations 
or scales are thick, and small pustules or ulcers are formed at the 
roots of the eyelashes. If the inflammation be long continued 
the eyelids become thickened, the eyelashes fall out, the eyes are 
irritated and their appearance is unsightly. 
1455. Treatment. The constitutional derangements 
must first be corrected by hygienic observances, and if tonics be 
necessary, my Golden Medical Discovery is advised. The eyes 
should frequently be bathed with milk and water, or a weak 
infusion of golden seal, or a lotion made from one or two grains 
of white vitriol 504) and one ounce of rose-water. Glycer- 
ine, either pure or medicated, may be applied at night to keep 
the surface moist. After thoroughly cleansing the eyelids, a 
preparation made from fifteen grains of borax, one-half ounce 
rose-water, and one-half ounce glycerine, may be applied and will 
produce good results. 
STYE. (Hordeolum.) 
1456. This affection is characterized by a red, hard swelling 
on the edge of the lid and is attended with considerable pain 676 
COMMON SENSE MEDICAL ADVISER. 
and inflammation. It is of the same nature as a boil and when 
it bursts, thick matter is discharged and a small part sloughs off, 
after which the swelling subsides and the lid heals. The treat- 
ment is the same as that for boils (1 874). 
TUMORS OF THE LIDS. 
1457. Tumors frequently form upon the lids. These may be 
removed by the knife. Careful discrimination, however, should 
be made between simple and cancerous tumors. 
EXCRESCENCES OF THE LIDS. 
1458. These have essentially the appearance of warts and 
may be removed from the lids by the use of caustics or the 
knife. The same precaution advised in the preceding affection 
applies equally well to this, viz: to distinguish between simple 
excrescences and those of a cancerous nature. 
1459. Wild hairs or ingrowing of the lashes is of frequent 
occurrence. The lashes grow in toward the eye and produce 
irritation and inflammation of that organ. 
WILD HAIRS. (Trichiasis.) 
1460. Treatment. When but a small part of the eyelid 
is thus affected pulling out the lashes with a pair of tweezers 
may suffice, but they will grow in a similar manner again. When 
the eye is endangered by the irritation which the lashes produce, 
the treatment should be radical and relief may be effected by 
destroying the hair-bulbs in the margin of the lid. This may 
be done by the use of caustics, care being taken to protect the 
eye by an investment made for that purpose; or a surgical 
operation upon the lid will remove the affection. 
EVERSION OF THE LIDS. (Ectropium.) 
1461. This disease is characterized by the lid being drawn 
away from the eyeball which, deprived of its natural protection, 
is subject to irritation and inflammation with frequent ulceration 
of the cornea. 
1462. Causes. It generally results from the contraction 
of parts which have been wounded and are beginning to heal, as 
in burns, scalds or cuts. It may be caused by paralysis of the DISEASES OP THE EYE. 
677 
muscle which surrounds the eye. Not long since I had occasion 
to operate upon a case in which eversion of the lids was caused 
by contraction of a wound in healing. A distinguished surgeon 
of New York had removed a tumor from the cheek of the 
patient, and in healing, the skin had contracted so much as to 
result in eversion of the lower lid. 
1463. Treatment. If paralysis be the cause of this affec- 
tion, appropriate constitutional treatment is advised. If caused 
by contraction of wounds or burns, a surgical operation is the 
only remedy. The operation consists in removing a part of the 
tissue, as shown by the black lines in Fig. 167, which represents 
the incisions as made in operating, and bringing the edges of the 
Fig. 167. 
Fig. 168. 
Ectropium immediately after op- 
eration, with the Sutures in 
position. 
Ectropinm before Operation. 
wound together, and holding them in position by means of pins 
and silk thread, applied as represented in Fig. 168. If too little 
of the superabundant tissue be removed, the operation will only 
partially relieve the difficulty. If, on the other hand, too much 
be taken away, inversion of the lids will result. When prop- 
erly performed, the operation is successful, and leaves little 
or no disfiguration. 
INVERSION OF THE LIDS. (Entropium.) 
1464. This disease of the eyelid is exactly the reverse of the 
preceding; the edge of the lid and the lashes are turned toward 
the eye. If this condition be continued, the result will be inflam- 
mation, caused by the irritation of the eyelashes, as described 
under Wild Hairs. 678 
COMMON SENSE MEDICAL ADVISER. 
1465. Causes. It may be caused by inflammation or 
thickening of the conjunctiva, or from flaccidity of the adjacent 
tissue. 
1466. Treatment. Astringents, or nitric acid may be 
applied to produce contraction of the skin. If, however, these 
do not afford relief, a surgical operation should at once be per- 
formed, since prolonged irritation is dangerous to the eye. A 
portion of the lid should be removed, while the margin remains 
uncut, and the edges of the wound brought together to heal. 
ADHESION OF THE LIDS. 
1467. Adhesion maybe of two kinds, viz: (1.) Where the 
margins of the lid adhere, and the globe of the eye remains free, 
which is caused by burns, wounds, ulcerations, and sometimes 
inflammation. (2.) Where the conjunctiva—surface of the eye 
—and one or both lids adhere. This deformity is sometimes 
congenital. 
1468. Treatment. In either case, the treatment is sur- 
gical, and consists in separating the adhesions by means of a 
knife, and applying ligatures. Care must be taken lest the 
structures of the eye be wounded. 
DISEASES OF THE EAR. 
1469. The ear is liable to maladies which occasion severe suf- 
fering and oftentimes result in structural lesions and total 
deafness. 
EARACHE. (Otalgia.) 
1470. Earache is of frequent occurrence, especially among 
children. Sometimes the pain is neuralgic, again it is inflamma- 
tory, and is increased by a recumbent posture. 
1471. Causes. Exposure to cold, inflammation of any 
portion of the auditory canal, rheumatism or disorders of the 
digestive apparatus are among the most prominent. Earache 
frequently occurs during the progress of measles or scarlet fever 
and is incident to feeble or scrofulous constitutions. When it 
has once occurred it is quite liable to return, even when no cause 
can be assigned therefor. 
1472. Symptoms. When the pain is neuralgic, it usually DISEASES OF THE EAR. 
679 
begins at night, is severe, lancinating and darting, but remits 
toward morning and the patient may be comparatively free from 
it during the day. If the pain result from inflammation it comes 
on gradually and does not entirely disappear until the cause is 
arrested. It is attended with noises in the ear, as singing, buz- 
zing, roaring, etc., and an examination reveals the auditory canal 
red, swollen and inflamed, or entirely obstructed. The pulse is 
quick, the tongue coated, the skin dry and hot and general symp- 
toms of fever appear. 
1473. Treatment. When constitutional derangement 
exists, remedies should be administered appropriate to the dis- 
ease. When earache is a sequence of measles or scarlet fever, 
alteratives are recommended. If the pain be neuralgic,, quinine 
and nux vomica, alternated with belladonna may be given, after 
which my Golden Medical Discovery and Purgative Pellets will 
be found beneficial. If the pain be indicative of inflammation, 
a spirit vapor-bath should be administered, the ear carefully 
steamed and my Compound Extract of Smart-Weed in some 
diaphoretic infusion taken in suitable doses. Aconite and bella- 
donna may also be used, and as soon as the inflammation begins 
to abate, alteratives are indicated. The above treatment may 
not give immediate relief, but is designed to effect a permanent 
cure. 
1474. Palliative treatment or that which will give present 
relief is desirable and may be obtained from simple household 
remedies, such as sweet-oil, camphor and oil, glycerine, a roasted 
onion or a toasted biscuit moistened in hot vinegar and applied 
to the ear. A little tuft of cotton or wool, saturated in a mix- 
ture of two grains of gelsemin and one of morphine dissolved 
in a drachm of glycerine and placed in the ear will rarely fail to 
give relief. 
PURULENT DISCHARGE FROM THE EAR. 
(Otorrhcea.) 
1475. This affection, which is of frequent occurrence, is the 
result of inflammation. The discharge varies in character and 
quantity. Sometimes it is thin and watery, again it is thick, 
creamy and of a yellow or greenish color and very offensive. 680 
COMMON SENSE MEDICAL ADVISER. 
1476. Cadges. The external part of the ear may be in- 
flamed and give rise to this discharge, or the tympanum (ear- 
drum) and adjacent parts may become diseased and suppuration 
follow. It may be occasioned by injuries, exposures to cold and 
vicissitudes of climate, or it may be induced by scrofula and 
translation of eruptions of the skin, or polypus of the ear. 
1477. Symptoms. There is severe earache, headache, 
and swelling of the glands of the neck, all of which are symp- 
Fig. 169. 
Examination of the external ear and tympanum by the speculum and mirror. 
toms of inflammation. As soon as the discharge takes place 
the inflammation subsides. The existence of this disease is very 
readily determined, but there is oftentimes much difficulty ex- 
perienced in ascertaining its course and to what extent the tissue DISEASES OP THE EAE. 
681 
has become involved. By means of the speculum and mirror, 
as illustrated in Fig. 169, the diseased structure can readily be 
brought to view. 
1478. Treatment. When the inflammation is acute and 
the pain severe, a spirit vapor-bath is advised, and the perspira- 
tion should be kept up with my Compound Extract of Smart- 
Weed, and small doses of aconite. When the disease is 
chronic, or when it results from eruptive fevers, an alterative 
and tonic course of treatment is recommended, for which 
my Golden Medical Discovery and Purgative Pellets are 
unequaled; hydrastis, dogwood and other tonics, may also be 
given. The ear should be thoroughly syringed two or three 
times a day with tepid water and Castile soap. My Nasal Douche 
is preferable to a syringe, since the force of the current may be 
regulated by elevating and lowering the Douche, or by com- 
pressing the flexible tube between the thumb and finger. Dr. 
Sage’s Catarrh Remedy is excellent for cleansing the ear, and 
promoting restoration of the diseased parts. When the dis- 
charge is profuse, mild astringents are frequently beneficial, and 
may be used with the Douche. If ulcers be visible, nitrate of 
silver or sulphate of zinc may be applied with a fine brush, but 
should be used with great care. When morbid growths produce 
the discharge, they should be removed by a skillful surgeon. 
If hardened wax be the cause of the discharge, it should be 
softened, and removed with suitable instruments, after which a 
warm infusion of hydrastis may be applied with the Douche. 
DEAFNESS. 
1479. Deafness may arise from obstruction of the eustachian 
tube, affections of the tympanum, obstruction of the external ear, 
or paralysis of the auditory nerves. 
1480. Obstruction of the Eustachian Tube. 
By reference to Fig. 63, it may be seen that the eustachian tube 
establishes a direct communication between the middle ear and 
the cavity of the pharynx. It is obvious that any obstruction to 
this passage will impair the hearing. 
1481. Causes. These are catarrh, and chronic inflammation 
of the lining membrane which becomes thickened and fills the 
cavity of the tube; also enlargement of the tonsils, which, being 682 
COMMON SENSE MEDICAL ADVISER. 
in close proximity to the orifice of this canal, encroach upon the 
passage and necessarily obstruct it. 
1482. $yiliptom§. Bubbling, cracking sounds in the 
ear, and a disagreeable sensation extending from that organ to 
the throat. In some cases it is difficult to ascertain the character 
of the sound, and whether or not the noises are produced by air 
in the eustachian tube. By use of the Otoscope and Politzer’s 
Air-bag, as illustrated by Fig. 170, the aurist can readily hear 
the sounds and determine their nature. 
1483. Treatment. 
If the affection be caused 
by nasal catarrh or en- 
largement of the tonsils, 
the treatment should be 
similar to that prescribed 
for these 878). 
If the thickening of the 
tube be so far from the 
opening that the Catarrh 
Remedy cannot be made 
to reach the diseased 
parts, the eustachian ca- 
theter may be used. Al- 
teratives should also be taken, and my Golden Medical Discovery 
is advised. 
Fig. 170. 
Examination of the Internal Ear and Eustachian 
Tube, by the Otoscope and Air-bag. 
1484. Affections of the Tympanum are all liable 
to result in thickening or perforation, which may terminate in 
complete destruction of this organ. 
1485. CatISC§. These affections are incident to a scrofu- 
lous diathesis, and may result from external violence, as blows or 
injuries of any kind. The tympanum is liable to be ruptured by 
foreign substances entering the ear, or by concussions of air, as in 
artillery firing. The perforation is more generally due to inflam- 
mation or ulceration, the structure giving way to allow the 
escape of matter, while thickening is usually occasioned by 
chronic inflammation of the tympanum. 
1486. Symptoms. Dullness of hearing, giddiness, hissing, 
puffing, rattling sounds in the ears. By closing the mouth and 
nostrils, and attempting to expel the air, it will find exit through DISEASES OF THE EAE. 
683 
the ear, if there be perforation of ‘the tympanum and the eusta- 
chian tube be unobstructed. 
1487. Treatment. In a strumous diathesis alteratives 
should be employed. Local applications, as nitrate of silver, 
iodine, hydrastin, myricin, sanguinarin, etc., may be used under 
the direction of a competent aurist. Cleanliness is absolutely 
necessary. When there is perforation or destruction of the tym- 
panum, the hearing may be greatly improved by the insertion of 
an artificial one. Thickening of the tympanum may be remedied 
by alteratives and local applications. 
1488. Obstruction of the External Ear. Any 
obstruction of the external ear prevents sounds from coming in 
contact with the tympanum, and thus produces deafness. 
1489. Causes. Morbid growths, as tumors or polipi ob- 
structing the passage. Any foreign bodies, as insects, beans, 
peas, kernels of corn, cherry-stones, slate-pencils, bits of wood, etc., 
getting into the ear and closing the auditory passage. If from 
any cause, as narrowness of the canal or neglect, wax remains in 
the ear, it may harden and completely obstruct the passage, 
or destroy the tympanum. 
1490. Treatment. If the obstruction be due to tumors 
or polypi a surgical operation is necessary for their removal, 
after which constitutional treatment may be adopted. Insects 
may generally be removed by putting a few drops of oil or 
warm water into the ear. When this fails they should be re- 
moved with a delicate pair of forceps. When beans, corn, peas 
and similar substances are lodged in the ear all efforts to with- 
draw them with such improper instruments as pins, knitting- 
needles, etc., are useless and quite liable to force them still 
further into the ear. Sometimes, however, a loop of fine wire 
is effectual in removing them. Again, by dropping oil or gly- 
cerine into the ear and lying on the affected side these foreign 
substances will sometimes work their way out. If these methods 
fail a skillful surgeon should at once be consulted. It is a com- 
mon mistake to manipulate the ear in vain endeavors to remove 
foreign substances, thereby inducing inflammation. If hardened 
wax obstructs the passage, warm water, applied with my Nasal 
Douche, may be used to soften it, after which it may be removed 
with forceps and a small scoop, and the ear moistened with 684 
COMMON SENSE MEDICAL ADVISER. 
glycerine. After the removal of the hardened wax, if the ear 
should ulcerate or become inflamed, alteratives may be taken and 
the ear cleansed with Dr. Sage’s Catarrh Remedy. A lotion 
of borax or an infusion of golden seal-root may also be used. 
1491. Dryness of tlie Ear. Sometimes this occasions 
deafness. Little or no wax is secreted and the tympanum is 
very sensitive and easily ruptured. 
1492. Treatment. Alteratives will arouse the functions 
of the glandular system and my Golden Medical Discovery ful- 
fills the indication. Equal parts of glycerine and rose-water 
should be applied to moisten the dry and sensitive parts. 
1493. Paralysis of the Auditory IVerves. There 
is frequently considerable difficulty in distinguishing this affec- 
tion from organic diseases of the hearing apparatus. Especially 
is this true of physicians who do not make diseases of the ear 
a specialty. The affection is, properly speaking, an impair- 
ment of the functional powers of the auditory nerves. It is 
also a symptom of cerebro-spinal meningitis and other diseases 
affecting the spinal cord. 
1494. Causes. Doubtless it is often hereditary. Again, it 
may be induced by acute mental emotion, shocks or concussions, 
fainting, anaemia, use of liair-dyes, lead-poisoning, narcotics or 
quinine, masturbation, excessive sexual excitement, debauchery 
or old age. 
1495. Symptoms. Paralysis of the nerves sometimes 
occurs suddenly, again it is more gradual and follows severe dis- 
eases. There is little or no pain, but a feeling of uneasiness, 
dizziness and sometimes nausea and vomiting. There are ring- 
ing, buzzing sounds in the ear, sometimes musical, again harsh 
and unpleasant, doubtless due to the inability of the auditory 
nerves to correctly convey impressions to the sensorium. 
1496. Treatment. When this affection is due to anae- 
mia or depression of the nervous forces, tonics and alteratives 
are indicated. Give my Golden Medical Discovery, together 
with phosphate of iron, dogwood, nux vomica, hydrastis, etc. 
Hygienic regulations should he observed. Electricity and gal- 
vanism are beneficial, also the injection of ether through the 
eustachian tube. These agents, however, can only he applied by 
the professional aurist. I have in some instances benefited cases DISEASES OP THE SKIN. 
685 
of long standing by applying a preparation made from ten drops 
of mix vomica, ten drops belladonna, and one ounce of glycerine, 
two or three drops of which may be put in the ear three times 
a day. In thus briefly referring to the diseases common to the 
ear, I have intimated only such treatment as may be employed 
by the family, and incidentally suggested the advantages that 
may be derived from instruments which I commonly employ. 
If I should write more extendedly upon these maladies, giving the 
full details of the treatment, or report cases which have been 
cured under my management, it would be of little interest to the 
general reader. I will therefore content myself with simply 
saying that I have given my personal attention to surgical opera- 
tions, connected with the ear, and also have the services of a 
professional assistant, who is a regular physician of the Faculty 
at the World’s Dispensary, and devotes his time and services to 
the treatment of these diseases. 
1497. Few diseases are less understood by the majority of 
practitioners of medicine than those which affect the skin. They 
are situated where they may be readily examined by the senses of 
sight and touch, nevertheless physicians err in distinguishing 
these different affections, for which they are entirely inexcusable. 
Egregious blunders are constantly committed, even by eminent 
practitioners, and the consequence is, inappropriate treatment. 
To facilitate acquiring an accurate knowledge of these diseases, 
I shall group them together in classes according to their corres- 
pondence in general appearances and symptoms. To still further 
aid the reader in recognizing these various affections, I have had 
prepared, at considerable expense, colored representations of 
some twenty different varieties (see Colored Plates I, II, and III), 
which, although not representing all the minute subdivisions 
of these affections, show nearly all of the more common ones, 
which are embraced within my large experience in treating 
diseases of the skin. Much confusion prevails with medical 
writers in classifying these affections. The classification which 
I shall follow is the one arranged by that eminent dermatologist, 
Erasmus Wilson, and is as well designed as any to simplify the 
study of these diseases. 
DISEASES OF THE SKIN. 686 
COMMON SENSE MEDICAL ADVISEE. 
ECZEMATOUS AFFECTIONS. 
1498. Eczematous affections constitute a very important class 
of skin diseases, the prominent characteristics of which are erup- 
tion and itching. They are progressive in character, passing 
through all the successive stages of development, from mere red- 
ness of the skin to desquamation, or thickening of the cuticle. 
The disorders belonging to this group are Eczema, Psoriasis, 
Pityriasis, Lichen, Impetigo, Gutta Rosacea and Scabies or Itch. 
A careful examination of each of these diseases shows it to be 
a modified form of eczema, and therefore demanding similar 
treatment. 
1499. Eczema {Humid Tetter, Salt-rheum, Running Scall 
or Heat Eruption). The term “eczema” literally signifies erup- 
tion, and is used to designate the commonest kind of skin diseases. 
By the Grecians this disease was termed Psora (to rub), and by the 
Romans, Scabies (a word derived from scabere, to scratch). 
These terms, however, have been discarded, and are only useful 
in so far as they convey a good idea of the character of eczema. 
1500. In this disease, the minute blood-vessels are congested, 
causing the shin to be more vascular and redder than in its natu- 
ral state. There is an itching or smarting sensation in the 
affected pai'ts. The skin is raised in the form of little pimples 
or vesicles, and a watery lymph exudes. Sometimes the skin 
becomes detached and is replaced by a crust of hardened lymph, 
or it may be partially reproduced, forming squamae (scales). 
There are three stages of this disease, viz: (1.) Inflammation, 
swelling, and the formation of pimples or vesicles; (2.) Exuda- 
tion succeeded by incrustation; and (3.) The skin separates in 
little scales and sometimes becomes thickened. Rarely, if ever, 
does the disease pass through these successive stages, but it is 
modified by its location and the temperament of the patient. 
1501. The many varieties of eczema are designated according 
to their predominating characteristics. Thus when pimples or 
vesicles are abundant, it is termed, respectively, Eczema Papil- 
losum and Eczema Vesiculosum, a fine illustration of which may 
be seen in Colored Plate I, Fig. 1. Again, when characterized 
by the eruption of pustules, it is termed Eczema Pustulosum, a 
representation of which may be seen in Plate I, Fig. 2; and Plate I. 
Fjg.l. 
Fig. 2: 
Fig. 3 
Fig. 5 
Fig. 4. DISEASES OE THE SKIN. 
687 
when the prominent feature is the formation of scales, we term 
it Eczema Squamosum, as shown by the more highly colored 
portion of Plate I, Fig. 2. Other varieties are also mentioned 
as Eczema Erythematosum, in which congestion and inflammation 
are the predominant features, and Eczema Mucosum, so named 
from the mucous fluid exuded. Eczema is also designated, 
according to the situation of the eruption, as Eczema Aurium 
(of the ear), Eczema Labiorium (of the lips), etc. 
Eczema may be general or partial; in other words, the erup- 
tion may appear in patches or be distributed over the entire 
surface of the body.. The latter form often appears in infants, 
but rarely occurs in adults. Two or more varieties of the erup- 
tion may be associated, or one form may gradually develop into 
another. 
1502. Eczema Infantile. Infants and young children are 
peculiarly subject to this disorder, and if the disease be not 
promptly arrested it will assume the severest form and eventu- 
ally become chronic. The muscles are soft, the eyes are dull 
and expressionless and the little sufferer experiences the most 
excruciating torments. Frequently the wdiole body is covered 
with patches of eczema, the secretions are arrested and where 
the scales fall off, the skin is left dry and feverish. 
1503. Eczema has no symptoms proper, since the morbid 
feelings are due to constitutional debility, of which eczema is the 
result. The signs of eczema are redness, heat, an itching or 
smarting sensation, the formation of pimples or vesicles, exuda- 
tion, incrustation, the separation of the cuticle into scales and a 
gradual thickening of the skin. 
1504. Causes. Three forms of constitutional derange- 
ment predispose the system to eczema, viz: nutritive, assimi- 
lative and nervous debility. In the former there is a diminution 
of nutritive power, so that the patient becomes weak and emaci- 
ated. Assimilative debility is indicated by impaired digestion and 
a consequent suppression, or an abnormal state of the secretions. 
If occasioned by nervous debility, it will be accompanied by all 
the morbid conditions incident to irritation and exhaustion of 
the nervous system. Eczema may be excited by a violation of 
the rules of hygiene, as undue exposure to, or sudden transitions 
from, heat to cold, deficient or excessive exercise, impure air, 688 
COMMON SENSE MEDICAL ADVISER. 
improper clothing, etc., etc. Violent mental and physical ex- 
citement may predispose the system to the disease. It may be 
due to strumous diathesis. 
1505. Psoriasis. Psoriasis may be defined as a chronic 
form of eczema. The transition of the last stage of eczema into 
psoriasis is indicated by a tendency of the inflamed, thickened, 
scaly skin to become moist when rubbed. This disorder is never 
general except in cases of congenital eczema. It usually appears 
in patches in various portions of the body. The skin is parched 
and highly discolored. The hairs are harsh and scanty. The pa- 
tient is constantly tormented by an unbearable itching sensation 
and if the skin be rubbed it exudes a viscous or sticky fluid. These 
are the characteristic signs of psoriasis. It generally appears on 
the flexures (folds or crooks of the joints), the backs and palms 
of the hands, the arms and the lower portion of the legs. This 
disease is liable to be confounded with lepra, or lepra cdphos, 
(white leprosy). It may be distinguished from lepra (1) by its 
causes, which are irritation and disorder of the nutritive, assim- 
ilative and nervous functions, while leprosy is an hereditary 
affection having no dependence upon health; (2) by its pruritic, 
or itching character, which in leprosy is absent; (3) by the 
patient’s recovery—whereas leprosy is essentially incurable. 
1506. Pityriasis. (Branny Tetter, or Dandruff.) This 
affection is a mild form of psoriasis, from which it may be distin- 
guished by a more superficial congestion or inflammation of the 
affected part, the absence of swelling and the formation of 
smaller scales, having the form and appearance or fine bran. It 
generally appears on the scalp, sometimes extends over the face, 
and in rare instances affects the entire surface of the body. The 
signs peculiar to this disease are slight inflammation, itching and 
the formation of minute scales. With reference to the extent 
of the affection, it is termed pityriasis localis when it is confined 
to the face, scalp, hands or feet, and pityriasis diffusa, when 
the whole body is covered with patches of yellow scales. It 
is termed pityriasis capitis when confined to the head. This 
form of the eruption is liable to degenerate into favus (scald- 
head). 
1507. Pityriasis Rubra is a general or diffused form of the 
disease, and in its severest stages is the most interesting and DISEASES OE THE SKIN. 
689 
remarkable of eczematous affections. Hebra noted three cases 
of this disorder in his practice. In each instance it presented 
the following peculiarities, viz: The surface was of a bright red 
tint, but if pressed with the finger would assume a tawny yellow 
color. It was covered with minute branny scales, but there was 
scax-cely any itching and no excoriation or peeling of the cuticle. 
1508. Pityriasis Nigra is an affection peculiar to persons born 
in India. The peculiar characteristics of this disease are inflam- 
mation without exudation, the detachment of scales exposing a 
red, glazed surface, absence of itching or burning sensations, a 
healthful activity of the digestive organs, weakness and emacia- 
tion. But the prominent feature of the disease is the peculiar 
appearance of the skin. At times it appears as if covered with 
a layer of imbricated scales, as on a fish. Again, the intensely 
red surface is traversed by white parallel layers of cuticle in the 
form of plate armor. Colored Plate II, Fig. 7, is an admirable 
representation of this arrangement of the scales. If you pass 
the hand downward over the skin the surface will feel smooth 
and soft, if upvjard, it will feel rough and a large quantity of 
scales will be detached. 
1509. Causes. Pityriasis is caused by nutritive debility 
and is often associated with erysipelas, rheumatism and bron- 
chitis. 
1510. Lichen (Papular Hash). Lichen is a term used to 
designate an eruption of minute conical pimples, which are more 
or less transparent, red, and occasion great annoyance. The 
eruption is attended with a severe, hot, prickling sensation, as if 
the flesh were punctured with hot needles. The pimples contain 
no pus, but if opened, they exude a small quantity of blood and 
serum. This disease more frequently occurs between the ages of 
twelve and fifty, but occasionally appears during dentition, when 
it is called “ tooth rash.” The lichen pimples are sometimes 
dispersed singly over the skin and gradually subside, forming a 
minute scale, corresponding in position with the summit of the 
pimple. When the pimples appear in clusters, there is a diffused 
redness in the affected part, and if they be irritated, minute 
scabs will be formed. Lichen generally appears on the upper 
portion of the body, as on the face, arms, hands, back and chest. 
1511. The various forms of liohen are designated according 690 
COMMON SENSE MEDICAL ADVISER. 
to their causes, signs, location, manner of distribution, and the 
form of the pimples. 
Lichen Simplex is the simplest form of this disorder, and*is 
indicated by the appearance of minute pimples, which, when the 
distribution is general, are arranged like the blotches of measles. 
Sometimes the eruption is local and bounded by the limits of an 
article of clothing, as at the waist. In eight or ten days, the 
cuticle separates into minute scales, which are detached and 
thrown off; but a new crop of pimples soon appears and runs the 
same course, only to be succeeded by another, and thus the 
affection will continue for months and even years. 
In Lichen JDispersus, as the name implies, the pimples are dis- 
tributed over the entire surface of the body. The pimples are 
hard, and occasion an unbearable sensation of itching. This is 
the most common variety of lichen, and not unfrequently is a 
sequence of scabies (itch). 
Lichen Circumscriptus is an aggravated form of Lichen Sim- 
plex, and characterized by a circular arrangement of the pimples. 
The circumference which marks the limit of the patch is sharply 
defined. This form of lichen usually appears on the chest, hips 
or limbs, and is not unfrequently mistaken for ringworm. 
Lichen Strophulosus is a variety peculiar to infants. Derma- 
tologists recognize several subdivisions of this species, but the 
general characteristics are the same in all. The pimples are 
much larger than in the other forms of lichen, of vivid, red 
color and the duration of the eruption is limited to two or three 
weeks. 
Lichen Urticatus is also an infantile affection and begins with 
inflammation, which is soon succeeded by the eruption. In a 
few days the pimples shrink, the redness disappears and the skin 
has a peculiar bleached appearance. The eruption is attended 
by an intense itching sensation and if the skin be ruptured, a 
small quantity of blood will be discharged and a black scab 
formed. This variety of lichen is very obstinate and of long 
duration. 
Lichen Tropicus, popularly known as “ prickly heat,” is an 
affection which “ attacks Europeans in hot climates.” It is char- 
acterized by the appearance of numerous red pimples of an 
irregular form, distributed over those portions of the body Plate D. 
Fig. 6 
Fig. 7. 
Fig. 9 
p © 
Fig. 8 
Fig. 10. 
0 ,-,> p 
Fie.u 
Fig.13 
Fig.12 DISEASES OF THE SKIN. 
691 
usually covered by the clothing. It is attended with a fierce, 
burning, itching sensation, which is aggravated by warm drinks, 
friction of the clothing and the heat of the bed. The eruption 
indicates a healthy condition of the system—its suppression or 
retrocession is an unfavorable symptom, denoting some internal 
affection, as deratiged nutrition. 
In Lichen Planus, as the term indicates, the pimples are flat- 
tened. There is no sensation of itching or formation of scabs. 
The pimples are solitary, have an angular base and the fresh 
pimples formed appear on the spaces between their former 
eruptions. This affection usually attacks some particular region, 
as that of the abdomen, hips, chest, etc. Instances are recorded 
in which it appeared on the tongue and the lining membrane of 
the mouth. Sometimes it appears in patches, but even then the 
margin of each pimple can be discerned. 
Lichen Pilaris and Lividus are modifications of lichen sim- 
plex, the former being so named to describe the location of the 
pimples, i. e., surrounding the minute hairs which cover the 
body, especially the lower limbs. The term Lichen Lividus 
indicates the dark purplish hue caused by a torpid circulation 
and the consequent change of arterial into venous blood before 
leaving the pimples. Lichen Circinatus is a modified form of 
Lichen Circumspectus. The pimples in the center of the circu- 
lar patch subside and a ring is formed which gradually increases 
in size. When the rings become broken or extend in regular 
forms the affection is termed Lichen Gyratus. 
1512. Causes. Constitutional debility predisposes the 
system to this eruption. The exciting causes are irritation of 
the skin, strumous diathesis, dentition and any violation of 
hygienic rules. Although lichen is not a fatal disease, yet it 
tends to reduce the vitality of the system. 
1513. Impetigo. (Crusted Tetter or Scall.) Impetigo 
is a term applied to an inflammation of the skin, more severe 
and energetic in its character than that of the preceding affec- 
tions. I have found the predominating characteristics of eczema 
and lichen to be the presence of exudation in the former, and 
the absence of it in the latter. 
1514. Impetigo is marked by the formation of yellow pus, 
which raises the cuticle into pustules. There is a slight swelling, 692 
COMMON SENSE MEDICAL ADVISER. 
redness and the pus gradually dries up, forming an amber 
colored crust, a representation of which is given in Colored 
Plate I, Fig. 5. It soon falls, leaving the skin slightly inflamed, 
but with no scar. The pustules are sometimes surrounded by a 
cluster of smaller ones. 
1515. The varieties of impetigo are designated according to 
the distribution of the pustules. Impetigo Figurata, is charac- 
terized by the appearance of large clusters upon an inflamed 
and swollen surface, generally upon the face, but sometimes 
upon the scalp. This form is represented in Colored Plate I, 
Fig. 4. In Impetigo Sparsa the pustules are scattered over the 
whole body. 
The only affections for which impetigo is liable to be mistaken 
are erythema and variola, from either of which it may be dis- 
tinguished by the superficial inflammation incident to the former 
while in the latter it is intense. 
1516. Causes. The predisposing cause of impetigo is 
nutritive debility, and the exciting causes are irritation, impure 
air and errors of diet. 
1517. Crlltta Rosacea. (Rosy Prop). This affection 
is usually described by dermatologists under the name of Acne 
Rosacea, but Dr. Wilson has made an admirable distinction 
between these diseases. In his own words, “ Gutta Rosacea is 
the red and pimply face of the mid-period of life; a disease of 
inflammatory congestion and depending upon constitutional 
causes: Acne is a disorder of secretion, of nutrition, of growth, 
and the development of the cutaneous tissues.” 
1518. It is a progressive disease, and its successive stages of 
development mark the several varieties, as Gntta Rosacea Ery- 
thematosa (redness), Papulosa (pimples), Tuberculosum (tuber- 
cles), Pustulosa (pustules). This affection is attended with heat, 
itching and throbbing. The pustules contain serous lymph, 
which exudes if the cuticle be broken, and forms a crust at the 
summit of the pustule. 
This eruption often .appears on the face of persons addicted 
to intemperate habits, and has thus received the name of “ rum 
blossom.” 
1519. Cause. It is essentially a chronic affection, and de- 
fends upon constitutional causes. DISEASES OP THE SKIN. 
693 
1520. Scabies. {Itch.) This disease is characterized by 
a profuse scaliness of the skin, by an eruption of pimples, 
vesicles, and in rare instances of pustules (festers). Its prom- 
inent feature is an intense itching, so aggravating that, in many 
instances, the skin is torn by the nails. Unlike other diseases 
of the skin, it is not due to inflammation, but is caused by 
animalculse, or little animals termed by naturalists the acarus 
scabei. This minute animal burrows in the skin, irritating it, 
and thus produces the scaliness and itching. The vesicles are 
comparatively few in number, and contain a transparent fluid. 
The pustules are only present in the severest forms or when the 
skin is very thin and tender. It is then termed “ pustular itch.” 
1521. The parts usually affected are the hands, flexures of 
the joints, and the genital organs. Cases are recorded in which 
the scabies appeared upon the face and head, but they are of 
rare occurrence. The activity of the animalcula?, is modified by 
the vitality of the victim. In persons of a vigorous constitution, 
they will rapidly multiply, and in a few days after their first 
appearance, will be found in almost every part of the body. 
1522. The scabies JVorvegica lioeckii, so named because 
first noticed in Norway by the eminent European physician, 
Boeck, is characterized by the formation of a thick, hai'd crust, 
containing vast numbers of dead animalculse, their ova and faecal 
matter. 
1523. Scabies is not confined to any age or sex, but chiefly 
affects persons of filthy habits. This disease can only be com- 
municated by contact, or by articles of clothing worn by an 
infected person. There are certain indications which predispose 
the system to infection, such as robust health, a hot climate, 
uncleanliness, etc. 
1524. Treatment. In all the varieties of eczematous 
affections, except scabies, the treatment of which will hereafter 
be separately considered, remedies employed with a view to the 
removal of the constitutional fault are of the greatest import- 
ance. The eruption upon the skin is but a local manifestation 
of a functional fault, which must be overcome by alterative 
remedies. All the emunetory organs should be kept active. 
To open the bowels administer a full cathartic dose of my 
Pleasant Purgative Pellets. Afterwards they should be used in 694 
COMMON SENSE MEDICAL ADVISEE. 
broken doses of one or two daily, in order to obtain their peculiar 
alterative effects. The use of my Golden Medical Discovery 
is also necessary to secure its constitutional remedial benefits. 
As a local corrective to relieve the itching and disagreeable 
dryness of the skin, add half an ounce of blood-root to half 
a pint of vinegar, steep moderately for two hours, strain and 
paint the affected parts once or twice daily with the liquid. 
Every night before retiring apply glycerine freely to all the 
affected parts. Or dissolve one drachm of oxalic acid in four 
ounces of glycerine and anoint the skin freely. An infusion of 
black-walnut leaves applied as a lotion to the affected parts has 
also proved beneficial. The application of my Golden Medical 
Discovery to the skin, at bed-time, will also prove an excellent 
local remedy in these skin diseases. The surface of the body 
must be kept clean by frequently bathing it, and thus stimu- 
lating its capillary vessels to healthy activity. All varieties 
of eczematous affections, excepting scabies, will only be tem- 
porarily relieved by external applications, while the radical cure 
depends upon a protracted use of alterative medicines. There- 
fore, I would again remind the reader of the necessity of keeping 
the bowels active, and removing all morbid taints of the blood 
and faults of the secretory organs by the use of the Golden 
Medical Discovery. 
1525. The successf ul treatment of Scabies generally requires 
only local applications, for the object to be attained is simply 
the destruction of the little insects which cause the eruption. 
Happily we possess an unfailing specific for this purpose. Nu- 
merous agents have been employed with success, but sulphur 
enjoys the greatest reputation for efficacy, and since it is per- 
fectly harmless I advise it for this class of diseases. Take a 
quantity of the flowers of sulphur and mix with sufficient lard to 
form a good ointment. Having first divested the body of 
clothing, anoint it all over freely, and rub the ointment thor- 
oughly into the pores of the skin while standing before a hot 
Are. The application should be made at night before retiring, 
and the patient should wear woolen night-clothes or lie between 
woolen blankets. In the morning after the application, the 
patient should take a warm bath, washing the skin thoroughly 
and using plentifully of soap. This treatment must be repeated DISEASES OF THE SKIN. 
695 
two or three times to be certain of a perfect eradication of the 
disease. After this course of treatment, the wearing apparel, as 
well as the bed-clothes, should be thoroughly cleansed, as a pre- 
caution against a return of the disease. 
ERYTHEMATOUS AFFECTIONS. 
1526. Many of our time-honored writers classified the erup- 
tive fevers, such as scarlatina and rubeola, with the slight 
flushing of the face known as rash. There is an obvious dis- 
tinction between them, hence I have treated the former in my 
chapter on fevers, and shall consider in this connection erythem- 
atous affections proper. I found the prominent features (erup- 
tion and itching) of eczematous affections to be purely local. 
But erythematous affections are remarkable for their symptoms 
of constitutional disorder. Each of these affections is preceded 
by intense febrile excitement and nervous debility. In brief, the 
local manifestations are simply signs of general internal disorder; 
hence, the treatment should be directed to the restoration of the 
general health of the system. This group includes Erythema 
(proper), Erysipelas and Urticaria. As Erysipelas has been 
considered with the eruptive fevers in a preceding part of this 
volume it will be omitted here. 
1527. Erythema. A vivid and partial flushing of the 
face is produced by a superficial inflammation of the skin, 
termed erythema. There are many stages of this disease, from 
the instantaneous transient flush caused by emotional excite- 
ment, to the protracted inflammation and swelling of JEh'ythema 
Nodosum. 
The affection is characterized by a flush which is at first a 
bright vivid scarlet but changes to a deep purplish tint. There is 
a slight elevation of the skin, sometimes accompanied by itching. 
In the second stage of development, the flush subsides, the skin 
has a yellowish or bruised appearance and a few minute scales are 
formed. In erythema papulosum (a fine representation of which 
is given in Colored Plate III, Fig. 18), there is an eruption of 
red pimples or pustules. The prominent feature of erythema 
nodosum, a variety of erythema which affects those portions of 
the skin exposed to the sun, is the appearance of a large 
swelling, usually lasting four or five days and attended by the 696 
COMMON SENSE MEDICAL ADVISER. 
constitutional symptoms — nausea, fever, languor and despond- 
ency. The disease is associated with the symptoms incident to 
a disordered nervous system and sometimes results fatally—in 
other cases it terminates in melancholy and mania. 
1528. Causes. The predisposing causes of erythema are 
constitutional debility, change of climate and temperature and 
irritating food or medicines. Locally it may be produced by 
friction and the heat of the sun. 
1529. Urticaria. {Hives or Nettle-Rash.) This word is 
from urtica, signifying a nettle; it is a transient affection of the 
skin indicated by a fierce, burning, itching sensation and a devel- 
opment of pustules, or white blotches of various forms. A repre- 
sentation of this eruption is given in Colored Plate III, Fig. 17. 
It is appropriately named nettle-rash from its resemblance to the 
irritation caused by the sting of a nettle. There is the same 
sharp, tingling sensation and a similar white wheal, or blotch 
caused by the muscular spasm of the corium, a layer of the skin. 
Urticaria may be either acute or chronic. Acute urticaria is 
always preceded by febrile symptoms and the attack is indicated 
by a sudden congestion of the skin, followed by a slight swell- 
ing or elevation of the affected part. When the congestion 
subsides the skin has a bruised appearance. In chronic urticaria 
the febrile symptoms are wanting. 
1530. Causes. The exciting causes of urticaria are gastric 
disorder, irritation of the mucous membrane, or a sudden ner- 
vous shock. The predisposing cause is conceded to be assimila- 
tive and nervous debility. Hence it frequently accompanies 
purpura (land scurvy) and rheumatism. The skin of some per- 
sons is so susceptible to irritation that urticaria can be kindled at 
any moment by excitement, as an animated conversation or by 
the simple pressure of the hand. 
1531. Treatment. The proper treatment for simple 
erythema consists in applying to the affected parts a little lime- 
water and sweet-oil or glycerine, with the use of warm baths and 
mild cathartics. This is generally sufficient to effect a cure, but 
should it fail, my Golden Medical Discovery, taken three times 
a day for a little while, will overcome the disorder. 
1532. For Urticaria, my Pleasant Purgative Pellets should 
be administered in sufficient doses to move the bowels, the skin Plate III 
Fig. 14^ 
Fig. 15. 
Fig. 16 
Fig. 20. 
Fig. 17 
FiO 18 
Fig 19. DISEASES OF THE SKIN. 
697 
bathed with warm water rendered alkaline by the addition of 
common baking soda or saheratus; and if there be febrile symp- 
toms, a little aconite or veratrum may be administered. In the 
chronic form of the disease, the diet must be light, unstimulating 
and easily digested, the skin kept clean by frequent bathing, and 
fresh air and outdoor exercise freely taken. The somewhat pro- 
tracted use of my Golden Medical Discovery will result in the 
greatest benefit in this form of the disease. 
1533. The distinguishing feature of this group of cutaneous 
affections is the formation of bulla, or blebs, which are defined 
by Galen as “ eminences of the cuticle, containing a fluid.” Of 
the three affections classified under this group, only one, Pem- 
phigus, properly belongs to the order. Herpes and miliaria are 
vesiculce, yet the vesicles often attain the size of a bulla, and the 
remote and immediate causes are the same in all; hence the pro- 
priety of the classification to facilitate the suggestion of appro- 
priate treatment common to all. 
BULLOUS AFFECTIONS. 
1534. Herpes is an inflammation of the skin in which the 
eruption appears in patches of a circular form. On the second 
day, minute, transparent vesicles appear and gradually develop, 
becoming opalescent. On the succeeding days, they shrink and 
produce reddish brown scabs, which soon become hard and fall 
off, leaving deep, purplish pits. In adults, these vesicles some- 
times terminate in painful ulcers, caused by an irritation of the 
eruption. By some practitioners, herpes is regarded as a purely 
nervous disorder, from the fact that it is frequently accompanied 
by severe neuralgic pains. These pains are not constant, but 
occasional, and do not appear at any definite stage of the disease. 
Sometimes they precede and accompany the eruption. Other 
instances are recorded in which they remained many years after 
the disease had disappeared. The local and constant pain of 
herpes is a severe burning, prickling, itching sensation, which 
still remains after the scabs fall. 
The three general forms of this disease are herpes Zoster, 
Phlyctcenodes, and Circinatus. 
1535. In Herpes Zoster, or Shingles, the clusters of vesicles 
encircle one-half of the hody, frequently at the waist; hence it 698 
COMMON SENSE MEDICAL ADVISER. 
has received the name of zona or girdle. The vesicles often de- 
velop into bullae, and sometimes ulcerate. In Herpes Phlyctce- 
nodes, the vesicles are small, round, and irregularly distributed 
over the face, neck, arms and breast. This form is accompanied 
by febrile symptoms and offensive excretions. 
1536. In Herpes Circinatus, or Ringworm, the vesicles ap- 
pear in circular patches or rings. This is the mildest form of 
herpes, and is not attended by symptoms of constitutional dis- 
order. The various forms of herpes are represented in Colored 
Plate I, Fig. 3. 
1537. Causes. Herpes is not contagious. It is caused by 
vicissitudes of heat and cold, violent emotion, excessive exertion, 
irritation of the skin, and a general atony of the system. 
1538. Miliaria (from milium, signifying a millet seed), 
is the name given to an eruption of vesicles which are larger 
than those of eczema, but smaller than the bullae of herpes. At 
first the serum contained in the vesicles is perfectly transparent, 
and reflects the red tint of the underlying skin: hence the name 
miliaria rubra. But gradually it becomes milky and opalescent: 
hence the term miliaria alba. The vesicles of miliaria are gen- 
erally solitary, and appear on those portions of the body most 
liable to become heated and to perspire. The eruption is preceded 
by chills, languor, slight fever, intense thirst, a sharp prickling 
sensation of the skin, and profuse perspiration. The vesicles 
soon desiccate and are replaced by a new crop. 
1539. Causes. Miliaria is almost universally an accompa- 
niment of febrile disease and all disorders in which there occurs 
a profuse perspiration. The causes to which it may be traced in 
each instance are improper diet, impure air, burdensome cloth- 
ing, strong emotions, etc. 
1540. Pemphigus is a peculiar eruption which appears 
upon the limbs and abdomen. The affected part is of a bright 
red color and in a few hours small vesicles appear containing a 
transparent fluid. The vesicle soon develops into bullae, en- 
tirely covering the inflamed portion. The fluid becomes opaque 
and in a few hours escapes. The patch is then covered with a 
yellow scab. Pemphigus may be either acute or chronic. The 
acute form is subdivided according to the degree of inflam- 
mation, as pemphigus pompholyx in which it is severe, and DISEASES OP THE SKIN. 
699 
pemphigus benignus, when it is mild. The bullae of pemphigus 
are illustrated in Colored Plate III, Fig. 19. 
1541. Cause. Pemphigus is always caused by a vitiated 
state of the system. 
1542. Rupia is indicated by an eruption as large as a 
chestnut, and containing a wateiy fluid, which desiccates into a 
yellowish brown crust. A fine repi'esentation of rupia vesicles 
in both stages of development is given in Colored Plate II, 
Fig. 13. 
1543. Treatment. In all forms of herpes the admin- 
istration of a small dose of my Pleasant Purgative Pellets 
with the use of my Golden Medical Discovery in teaspoonful 
doses three times a day, will be followed by the happiest results. 
The skin should be kept clean by the use of the sponge-bath 
rendered alkaline by the addition of common baking soda or 
salseratus. The poi-tion of the body covered by the eruption 
should be bathed in a solution of sulphate of zinc, one ounce to 
a pint of water. 
Miliaria is generally associated with certain febi*ile diseases 
and its proper treatment consists in overcoming the febrile and 
other constitutional symptoms which accompany the disease. 
A hot foot-bath and small doses of aconite will suffice to remove 
the fever. If the stomach and bowels be in a vitiated condition 
as they ai-e apt to be, a mild cathartic may be administei’ed. 
1544. The treatment of pemphigus should consist in frequent 
alkaline sponge-baths, and covering the affected parts with poul- 
tices of slippery elm, which should be kept moist with vinegar. 
The constitutional treatment should embrace the persistent use 
of my Golden Medical Discovery. When the disease occurs in 
children it is most generally dependent upon deficient nutrition, 
and special attention must be given to the diet of the patient, 
which should be nutritious. Fi’esh air and outdoor exercise must 
not be neglected. 
The proper treatment of rupia does not differ from that sug- 
gested for pemphigus. 
NERVOUS AFFECTIONS OF THE SKIN. 
1545. In nervous affections of the skin, the natural sensi- 
bility may be increased, diminished or perverted. These morbid 700 
COMMON SENSE MEDICAL ADVISER. 
impressions arise from the nervous system. Although there are 
several varieties of these affections, yet being of minor import- 
ance, I shall omit their consideration and only speak of one of 
them in this connection. 
1546. Prurigo affects the entire surface of the body and 
imparts to the skin a parched, yellowish appearance. It is char- 
acterized by pimples and an intense burning, itching sensation. 
Rubbing and scratching only aggravate the skin which becomes 
covered with thin black scabs. A good representation of prurigo 
may be seen in Colored Plate II, Fig. 6. The itching sensations 
are sometimes caused by chilling the body, by overexercise 
and heat; allowing the mind to dwell upon the affection aggra- 
vates it. Prurigo is recognized under two forms, viz: Vul- 
which is a mild form; and Senilis, which chiefly occurs 
in old age and is more severe. The external genital parts of 
females are frequently affected with this disease which is aggra- 
vated by menstruation and uncleanliness. 
1547. Causes. This affection may be due to a vitiated 
condition of the blood, and is common to those who are greatly 
debilitated. It is frequently occasioned by uncleanliness, intem- 
perance, use of unwholesome food or by an impure atmosphere. 
1548. Treatment. To allay the itching, take glycerine, 
one ounce, add to it one drachm sulphite (not sulphate) of soda 
and half an ounce of rose-water and apply this to the affected 
parts. A solution made of borax two drachms, and morphine 
five grains, dissolved in six ounces of rose-water, makes an excel- 
lent lotion to allay the itching. If the disease be severe, it will 
be necessary to correct the vitiated condition of the blood by a 
protracted use of my Golden Medical Discovery and to aid its 
effects give one Purgative Pellet every day—not sufficient to 
operate as a cathartic, but only to secure its alterative influence. 
ALPIiOUS AFFECTIONS. (Scaly Skin Diseases.) 
1549. Differences of opinion exist with regard to the proper 
classification of these affections. I shall briefly consider Alphos, 
which some confound with Lepra. 
1550. AljlliOS, which from its Greek derivation signifies 
white, is characterized by circular, slightly raised, white spots. 
These eruptions vary in size from one line to two inches in DISEASES OP THE SKIK. 
701 
diameter, and may be scattered over the entire surface of the 
body, although they most frequently appear upon the elbows 
and knees. Alphos may consist of a single tubercle, or of large 
clusters constituting patches. The scales vary in color and 
thickness. In Colored Plate III, Figs. 14 and 15, are fine illus- 
trations of Alphos. When a person begins to recover from this 
affection, the scales fall off, leaving a smooth, red surface, which 
gradually returns to its natural coloi\ 
1551. This affection may be classified under three forms, viz: 
(1.) Alphos circincitus, which appears in circular places upon the 
limbs and fleshy parts of the body; (2.) Alphos guttatus, which 
occurs in groups; and (3.) Alphos diffusus, which is scattered 
over the entire body, sometimes occurring upon the face, head, 
elbows, or knees, and again upon the hands. It has no tendency 
to preseiwe the rounded form of the circincitus variety. 
This disease is more liable to occur in winter than in summer, 
although in some cases the reverse holds true. It may disappear 
for a time, only to return again with renewed vigor. It is not 
regarded as contagious. 
1552. Treatment. Thorough and protracted constitu- 
tional treatment is required, to overcome this disease. The 
Golden Medical Discovery should be taken internally and also 
applied locally to the affected parts. To every other bottle of 
the Discovery which is taken you may add one-half ounce of 
iodide of potash. One or two of my Pellets taken daily will 
prove a useful adjunct to the Discovery. 
1553. Locally, I have sometimes applied a lotion made of 
oxide of zinc one-half drachm, benzoic acid two drachms, mor- 
phine live grains, glycerine two ounces. Muriated tincture of 
iron one drachm, in one ounce of glycerine, makes an excellent 
local application. But whatever the local treatment may be, 
I chiefly rely upon the persistent use of the best alteratives. 
AFFECTIONS OF THE HAIR-FOLLICLES. 
1554. Taviis (Scald-IIectd) is a disease peculiar to the hair- 
follicles, and is indicated by the formation of small yellow crusts, 
having the form of an inverted cup. The eruption has a very 
offensive odor. When it appears in isolated cups, it is termed 
favus disperms, but it oftener occurs in largo clusters, as 702 
COMMON SENSE MEDICAL ADVISER. 
represented in Colored Plate II, Fig. 12, and is then termed 
favus confertus. It generally affects the scalp, but sometimes 
extends to the face and neck. 
1555. Cause. Favus is caused by nutritive debility, which 
results in a perverted cell-growth. 
1556. Sycosis (Barber's Itch) is an inflammatory affection 
of the hair-follicles of the face. The prominent features of the 
disease are redness and the formation of scales. It is peculiar to 
males. It has received various names, according to its predom- 
inating characteristics, as sycosis papular (pimples), tubercular 
(tubercles), and fungus (from its peculiar structure). Colored 
Plate II, Fig. 10, is a fine illustration of Sycosis as it appears on 
the cheek. 
1557. Causes. Various causes induce the appearance of 
Sycosis. The general causes are nutritive debility, vicissitudes 
of heat and cold and an exhausted state of the nervous system. 
It may also result from various chronic diseases, such as syphilis 
and dyspepsia. 
1558. Comedones, or Grubs, are due to a retention of the 
sebaceous matter in the follicles. The sebaceous substance un- 
dergoes a change, becoming granular and somewhat hardened. 
It gradually extends to the mouth of the follicle, where it comes 
in contact with the atmosphere, and assumes a dark color, as 
represented in Plate II, Fig. 8. This fact, together with its 
peculiar form when squeezed out of the skin, has won for it the 
name of “grub.” They often appear in great numbers on the 
face of persons whose circulation is not active, or those who are 
of a particularly nervous temperament. Stimulating baths and 
friction will prove very efficacious in removing these cylinders 
of sebaceous matter. If they are allowed to remain, they will 
produce an irritation of the skin causing an inflammatory disease 
known as 
1559. Acne or Stone-pocli. In the earliest stage of 
congestion, acne is characterized by minute hardened elevations of 
the skin, as shown in Plate II, Fig. 9, and is termed acne punctata. 
As the affection progresses a bright red pimple (see Plate II, 
Fig. 11) appears, having a conical form, hence the name acne 
coniformis. The pimple develops into a pustule containing 
yellow matter and is then known as acne pustulosa. This is DISEASES OF THE SKIN. 
703 
followed by a thickening of the tissues termed acne tuberculata. 
When the thicker skin is removed, it leaves a deep scar, hence 
the term acne indurata. 
1560. Causes. The remote cause of acne is nutritive 
debility. The immediate causes are rapid growth, anaemia, 
impx-oper food, errors of hygiene, mental exhaustion and numer- 
ous chronic diseases. 
1561. Treatment. The treatment of favus or scald-head 
should be commenced by shaving the hair off close to the scalp 
and washing the head thoroughly with soap and water. In 
some severe cases it may be necessary to soften the incrustations 
with poultices, following these with the free use of soap and water. 
Having thus exposed the scalp and thoroughly divested it of 
incrustations, apply to it the ointment of iodide of sulphur, 
which may be procured at any well kept drug store. It should 
be gently rubbed over the parts night and morning. The scalp 
must be kept perfectly clean throughout the treatment. Instead 
of the foregoing, the following may be applied: take oxalic acid 
ten grains, creosote twenty drops, water two ounces; mix. Fol- 
low the use of this lotion in half an hour by anointing the head 
freely with butter or lard. If a few drops only of mux-iatic 
acid be thoroughly incorporated with the butter or lard it will 
add gi*eatly to the efficacy of the treatment. But while local 
applications will relieve many skin diseases and mitigate suffer- 
ing, I cannot too strongly impi-ess upon the minds of my i-eaders 
the importance in this, as in all other chronic diseases of the 
skin, of persevering in the use of the best alteratives. Among 
this class of agents my Golden Medical Discovery stands pre- 
eminent. Its efficacy may be increased in this disease by adding 
to each bottle one ounce of the acetate of potash 569), and 
when thus modified it may be administered the same as if no 
addition had been made to it. 
1562. The treatment of sycosis (or barber’s itch) shduld be 
essentially the same as that suggested for favus (or scald-head) 
and will result in prompt relief and permanent cure. 
1563. Treatment of Acne. In the treatment of this, as in 
that of other diseases, we should seek to ascertain the cause and 
when possible remove it. Outdoor exercise, a spare, unstimu- 
lating diet and perfect cleanliness are of the first importance. 704 
COMMON SENSE MEDICAL ADVISER. 
The affected parts should be bathed in warm water and Castile, 
or what is better, carbolic soap. Washing the face in cold water 
generally aggravates the disease. As a local application to the 
little pustules, I have used with good results the following lotion: 
Take of oxide of zinc twenty grains, morphine five grains, 
glycerine two ounces; mix. First having washed the affected 
parts thoroughly, apply this compound. Our chief reliance, 
however, as in the preceding diseases, should be upon the per- 
sistent use of alteratives and mild cathartics or laxatives. 
FURUNCULAR AFFECTIONS. (Boil-like Affections.) 
1564. Under this head properly belong boils, carbuncles and 
styes, which have been considered in preceding portions of this 
volume and hence will be omitted here. With these affections 
Erasmus Wilson has grouped 
1565. EctSfiyina. This is a pustular disease, partaking 
somewhat of the characteristics of boils. The essential points 
of difference between ecthyma and boils are the free suppura- 
tion of the former throughout the whole pustule and the 
presence of a core of cellular tissue in the latter. 
1566. A fine illustration of the large pustules of ecthyma is 
given in Colored Plate III, Fig. 20. These pustules may be 
dispersed more or less extensively over the body and limbs, but 
most commonly are confined to the lower extremities. They are 
hardened and inflamed at their base, distended with deep yellow 
pus (matter), and distinctly circumscribed. The pustule com- 
mences as a small itching, tingling pimple (represented in Colored 
Plate at letter II), which increases in size until a little pus is 
formed on its summit as seen at I. The pustule discharges in 
about three days, and dries up into a yellowish gray or brown 
scab, as seen at K, in Colored Plate. If this be detached too 
soon, a small ulcer is left which dries up into a larger secondary 
scab, as seen at L. When this scab is separated the ulcerated 
condition of the skin is brought to view, as represented at M. 
This in turn becomes covered with a thick scab, which, when 
removed or allowed to drop off, leaves a pit still deeper than 
that left by its predecessors. At O, in Colored Plate III, Fig. 
20, may be seen a representation of a cluster of pustules in their 
crusted state. COENS, 
705 
1567. Canges. These pustules arise in consequence of 
constitutional debility and perversion of the nutritive functions. 
1568. Treatment. This must be both local and consti- 
tutional. The local applications should be such as will moder- 
ately stimulate the skin. Thorough washing of the affected 
parts night and morning with carbolic or juniper-tar soap and 
tepid water, followed with a dressing of resin ointment, which 
may be procured of the apothecary, will be a suitable local 
treatment. The proper constitutional treatment does not differ 
from that suggested for boils on page 462, 1 874. The promi- 
nent indication is to cleanse the blood, which is the great foun- 
tain of life, and good digestion, a fair skin, buoyant spirits, vital 
strength and soundness of constitution, will all be established. 
WARTS. 
1569. These excrescences appear most frequently upon the 
hands. Their causes are very obscure. If cut or punctured 
they exude a watery or bloody serum that, applied to the 
skin, is apt to produce others of the same kind. 
They may be removed by applying to them a drop of chromic 
acid and this treatment is much superior to the remedies usually 
recommended, which savor more of enchantment, sorcery, magic 
or hocus-pocus, than of science or common sense. 
CORNS. 
1570. Corns are Nature’s bulwark against oppression, her pro- 
test against pride. If this definition he deemed too indefinite or 
fanciful, another may be added, viz: Corns are abnormal protu- 
berances upon the feet or toes, thrown out as a protection to the 
delicate nerves beneath, to relieve them from the pressure caused 
by wearing tightly-fitting boots or shoes. Corns may vary much 
in size and are either hard or soft. Those formed between the 
foot and the boot are almost always hard. Those between the 
toes, caused by their pressure one upon another, are nearly always 
soft. When subjected to only the ordinary amount of pressure 
they may be painless, and occasion no great annoyance. But if 
from any cause the pressure be increased, the surrounding parts 
will become actively inflamed and give rise to much suffering 
and lameness. 706 
COMMON SENSE MEDICAL ADVISER. 
1571. Treatment. The first thing to be done is to re- 
move the cause. Substitute a more oomfortable boot or shoe, or 
make a hole in the leather over the corn to give it room. Do 
not, however, go from one extreme to another, and select a boot 
so large that it will allow the foot to move about and chafe the 
already irritated part. 
1572. Never attempt to extirpate a corn while there is active 
inflammation or great soreness in the surrounding tissues. This 
condition will usually disappear after the provoking cause is re- 
moved. If it does not, then apply to the part some soothing 
cerate or ointment. Having thus subdued the swelling and ten- 
derness, soak the foot in warm water to soften the corn, and pare 
it down well with a sharp knife. Then have ready some nitro- 
muriatic acid, and with a camel-hair pencil, or a sharp-pointed pine 
stick, apply a small drop to the corn. The surrounding parts 
should be protected with a thin layer of soda or salaeratus, or 
with a thin piece of leather, having a hole cut through it large 
enough to expose the corn. After using the acid, in the manner 
described, apply an adhesive plaster over the parts, and, on re- 
moving it a few hours later, the corn will usually come away 
with it. If it does not, apply a little more of the acid from time 
to time, until it can be thus removed. 
1573. A person who has never experienced the suffering aris- 
ing from an inversion of the toe-nail may think that the subject 
is unworthy of notice in this volume. Yet this affection some- 
times assumes formidable proportions, giving rise to great suffer- 
ing and requiring weeks and even months of treatment for its 
cure. 
This malformation consists of a curling down of the sides of 
the nail of the great toe, which grows into the flesh and gives 
rise to inflammation, swelling and suppuration. The part becomes 
extremely tender and irritable, so that a boot or shoe cannot be 
worn. In extreme cases the toe swells and fungous flesh develops 
to such an extent that all trace of the original form of the mem- 
ber is lost, and it becomes a large, unsightly tumor. A case is 
on record in which it became as large as a goose egg and the 
whole foot and leg were involved in the inflammation. Matter 
INGROWING TOE-NAILS. (Onyxis.) INGROWING TOE-NAILS. 
707 
was discharged from several openings, and the part was so sensi- 
tive and tender that the patient could not endure the weight of 
a fly upon it. 
The ease is liable to reach a serious condition like the one 
referred to, as the result of the savage and irrational treatment 
to which it is sometimes subjected by unskillful practioners; 
such as slitting the nail and pulling out the offending part with 
the forceps, or cutting it out with the knife, and treating the 
wound with acetate of lead or mercury. The result is that the 
nail grows inverted again, and is worse than it was previous to 
receiving such surgery. 
1574. Treatment. In the incipient stage relief may be 
given by softening the nail in hot water or weak lye, and then 
with a sharp knife cutting out a narrow trough or furrow in the 
middle of it, running lengthwise from the front edge to the 
root. This cut should not be deep enough to give pain. Nature 
immediately makes an effort to fill the crease that has been made, 
the nail grows toward the centre and draws away from the 
edges, thus giving desired relief. 
In advanced and serious cases, like the one referred to, resort 
must be had to more extended and efficacious treatment. In the 
first place the swelling, soreness and inflammation must be re- 
duced so that the part can be handled. To accomplish this, 
soak the toe an hour or two each day in warm, weak lye, and 
during the interval, poultice it with slippery-elm. It may 
require three or four days to reduce the inflammation. Then, 
wherever the nail is softened and most easily detached, press 
under it with a probe little pledgets of cotton to raise it. Also, 
press pledgets down at the sides and between the nail and the 
flesh which has risen up over it. Dress with some simple oint- 
ment to keep down the inflammation, bandage and keep the part 
moist with warm water. Twice a day the part should be soaked 
in weak lye and the- toe be thus dressed. Continue to push the 
pledgets under as the flesh cleaves from the nail, and cut away 
portions of it as fast as they become loose. In this manner the 
offending portion may be removed, the ulcers healed and there 
will be no return of the trouble. Should excessive granulation, 
or “ proud-flesh,” occur and prove obstinate, dust it with pow- 
dered blood-root 465) or burnt alum. 708 
COMMON SENSE MEDICAL ADVISER. 
FELON. (Whitlow.) 
1575. “Multum in Parvo” may well be said of this local 
affection, where within a little space so much pain is experienced. 
Its usual location is near the end of the finger, where the nerves 
of sensation are very numerous. Indeed, a more .favorable posi- 
tion to make itself felt could hardly be selected. The palm of 
the hand is occasionally the seat of its manifestation. The nerves 
of sensation here are not so numerous, but the number of tendons 
and ligaments involved, increases the severity of the local disease. 
Medical men recognize three or four varieties of felon, distin- 
guished from one another chiefly by the different tissues in which 
they originate. They may find their starting point between the 
periosteum (bonesheath) and the bone, or any where between 
that part and the skin. These nice distinctions, however, are 
not of any service to those for whom this work is written, and 
are therefore omitted with this mere allusion to them. 
1576. Causes. In a majority of cases, the cause is not 
apparent. It may be produced by some local injury, as a strain, 
a bruise or a puncture, especially if the latter be made by a 
poisoned instrument. 
1577. Symptoms. The first sensation experienced is a 
pricking or stinging pain, which might result from a wound 
inflicted by a sliver or briar. So close is this resemblance that 
the person is frequently deceived, and goes to prospecting with 
a needle or penknife for the supposed “thorn in the flesh but 
he fails to find it. Meanwhile it keeps “jabbing away” at inter- 
vals, or sometimes almost constantly, for two or three days, 
when the part becomes inflamed, begins to swell, and it is evident 
that the “ thing ” has come to stay, at least until it has run its 
usual course, terminating in suppuration. This will occur in from 
four to ten days, according to the distance the pus (matter) has 
to travel, and the nature of the obstructions it has to overcome 
before reaching the surface. If it be deep seated, pieces of the 
bone will be discharged. In very severe cases, a whole joint 
may be lost. When it occurs in the palm of the hand, it has 
been known to occasion such extensive destruction among the 
bones, cords and tendons, as to permanently impair the use of 
that member. FELON", 
709 
1578. Treatment. This part of the subject deserves 
special consideration, not only on account of the painful nature 
of the alfection, but also because of the serious consequences that 
so often result from it. 
If taken in season, thei’e is positively no necessity for per- 
mitting one of these troublesome pests to “ come to a head.” In 
the incipient stage, their further development is easily arrested. 
Many different applications are recommended for this purpose. 
It should be borne in mind, hoAvever, that success depends more 
upon compression—mere mechanical compression—than upon 
the medicinal properties of any poultice or liniment that can be 
applied. Hence, whatever is used must be bound on very tightly. 
One of the simplest, and yet one of the most efficacious remedies, 
if used in the early stages of the affliction, is the following: 
Take a raw egg, break and empty it, peel off the skin from the 
inside of the shell, and wind it around the finger over the seat of 
the pain. Put the inside, or wet side, next the skin. It should 
remain as applied ten or twelve hours, if the patient can endure 
it. The principle of its action is purely mechanical. As it dries 
it contracts with great force, and thus effectually compresses the 
affected parts. Any one who may doubt this, can easily test it 
upon his sound digit. If put on tightly at first, one will be glad 
to get rid of it within an hour. In the palm of the hand, of 
course, this appliance cannot be made available. 
One of the best medicinal preparations that can be used is finely 
pulverized salt wet with spirits of turpentine, bound tightly on 
the afflicted part and allowed to remain one or two days. It 
should be moistened from time to time with the turpentine, 
which can be done without removing the bandage. 
Poke-root (*([ 460) bruised and applied as a poultice is useful 
in the incipient stages. Soaking the finger for a long time in 
lye or lime-water, as strong and as hot as can be borne is highly 
recommended. However, I place more confidence in the first 
two remedies than in any and all others. 
After pus has once formed, nothing will be gained by post- 
poning an operation to let it out. Much suffering will be 
avoided by lancing it as soon as the throbbing pain indicates that 
pus has formed. When this operation is postponed, the pus 
burrows and extends under the strong fibrous sheath of the bone 710 
COMMON SENSE MEDICAL ADVISEE. 
and causes far greater destruction to tissue than when it is early 
released. The point selected for this operation should be as near 
as possible where the swelling would naturally break. A com- 
mon thumb-lancet or sharp-pointed bistoury is the instrument 
usually selected with which to make the incision, and it should 
be made to cut completely down to the bone, in order to lay 
open the fibrous sheath surrounding it and under which the pus 
usually forms. The parts should be laid open by a deep, free 
incision. No half-way surgical procedure will be of any benefit. 
Relief from the pain will be instantaneous, if the operation is 
thoroughly performed. I have frequently produced local anaes- 
thesia of the finger to be operated upon, by throwing upon it a 
spray of sulphuric ether and rhigolene. This produces a mo- 
mentary freezing, during which the felon may be lanced without 
pain to the patient, after which the parts suddenly thaw and the 
circulation and sensibility are restored. After the operation the 
wound may be treated with warm poultices, ointments or salves. 
WOMAN AND HER DISEASES.* 
1579. An imaginative poet avers that woman is the link con- 
necting heaven and earth. True it is, we see in her the embodi- 
ment of purity and holiness, heavenly graces, the most perfect 
combination of modesty, devotion, patience, affection, gratitude, 
and loveliness, and the perfection of physical beauty, blending 
grace in outline, with delicacy and compactness of texture. We 
watch with deep interest the steady and gradual development 
from girlhood to womanhood, when the whole person improves 
in grace and elegance, the voice becomes more sonorous and 
melodious, and the angles and curvatures of her contour become 
more rounded and amplified, preparatory for her high and holy 
trust. 
1580. The uterus and ovaries, with which her whole system 
is in intimate sympathy, render her doubly susceptible to inju- 
rious influences and a resulting series of disease, from which the 
other sex is entirely exempt. By their sympathetic connections, 
they wield a modifying influence over all the other functions of 
the system; they mould her character, beautify and perfect her 
form. Physically and mentally, she is man modified, perfected, 
* For an illustration of the generative organs of woman, see page 217. MENSTRUATION AND ITS DISORDERS. 
711 
—the last and crowning handiwork of God. When, therefore, 
this structure so wondrously endowed, so exquisitely wrought, 
and performing the most delicate and sacred functions which 
God has ever entrusted to a created being, is disturbed by dis- 
ease, when the nicely-adjusted balance of her complex nature 
deviates from its true and intended poise, the most efficient aid 
should be extended, in order that the normal equilibrium may be 
regained, her health restored, and her divine mission, on which 
human welfare so largely depends, be fulfilled. Its importance 
should elicit the best efforts of the highest type of mind, the ripe 
development of genius, and the most studied manipulation, with 
the choicest, rarest, and purest medicinal elements in the whole 
range of nature. 
1581. As the remedial management of those diseases peculiar 
to women has entered very largely into our practice at the 
World’s Dispensary, involving the treatment of many thousand 
cases annually,we have been afforded great experience in adapting 
remedies for their cure, enabling us to meet their requirements 
with greatly increased certainty and exactness. As the diamond 
and other of the most precious stones are hidden away in nature’s 
secret recesses, requiring patient toil and diligence to unearth 
them, so by the same unceasing toil we have secured the most 
precious and valuable remedial agents designed for woman’s use, 
from recesses in vegetable life heretofore unexplored, with which 
to gem the world of medicine. 
MENSTRUATION AND ITS DISORDERS. 
1582. The office of the ovaries is to furnish ova or germs, 
which are the stimuli to the functions of the uterus or womb, 
(see page 217). The functional duties of the latter organ are 
(1) to secrete mucus; (2) to exude the menses; (3) to secrete the 
decidua 301); (4) to contain and nourish the foetus and (5) to 
effect its expulsion. 
1583. Menstruation, also termed the menses, monthly visita- 
tion, catamenia, menstrual flow, courses, periods, etc., usually 
makes its appearance in the human female between the twelfth 
and fifteenth years, at which time the reproductive system under- 
goes remarkable changes. A marked characteristic of menstru- 
ation is its regular return about every twenty-eight days. The 712 
COMMON SENSE MEDICAL ADVISER. 
menstrual flow usually continues from three to six days, and the 
discharge seems to be ordinary blood, which, during its vaginal 
passage, becomes mixed with mucus, and is thereby deprived of 
the power of coagulation. The quantity exuded varies from four 
to eight ounces and the amount suitable to the health of one 
person, may be excessive and weakening to another. This func- 
tion is regarded as regular when its effect upon the system is 
favorable, for whatever organic process directly contributes to 
the health must be considered normal. It occurs at regular 
intervals for about thirty years, when menstruation and the 
aptitude for conception simultaneously ceases. 
1584. The departures from healthy menstruation are numer- 
ous. The more important of them may be classed as follows: 
(1.) Amenorrhoea; (2.) Dysmenorrhoea, and (3.) Menorrhagia. 
AMENORRHOEA. 
1585. The tei’m Amenorrhoea signifies absence of menstrua- 
tion when it should occur. It may be considered under two 
general heads: (1.) When it fails to be established at the proper 
age; and (2.) When, after having made its appearance, it ceases 
to return at the usual periods. The term retention has been 
applied to the first, and that of suppression, to the latter. Men- 
struation may fail to be established in consequence of (1) organic 
defects, or (2) from some abnormal condition of the blood and 
nervous system. 
1586. Malformation of the Vagina. Reten- 
tion of the menses may result from malformation of the vagi- 
nal canal, which sometimes terminates before it reaches the 
womb, being simply a short, closed sac. If the uterus and 
ovaries be perfect, all the feminine characteristics will be mani- 
fest, and a vaginal exploration will disclose the nature of the 
difficulty. If, however, the side# of this passage adhere in con- 
sequence of previous inflammation, they may be carefully 
separated by surgical operation, and this function be restored. 
1587. Absence or Malformation of the 
Womb, The uterus may he malformed or entirely absent, 
and yet there be an inclination, or symptoms indicative of an 
elfort, to establish this function. The individual may be delicate 
in organization, graceful in bearing, refined and attractive in all AMESTOEllIICEA. 
713 
feminine ways, and yet this organ be so defective as to preclude 
the establishment of the menstrual function. Sometimes there is 
merely an occlusion of the mouth of the uterus, the perforation 
of which removes all difficulty. In others, the neck of the womb 
is filled with an adventitious substance, or the walls of its canal 
are adherent as the result of inflammation, and may be separated 
by a small silver or ivory probe, and the menses thus liberated. 
1588. Imperforate Hymen. The hymen is a circular 
or semi-lunar (half-moon) shaped membrane, which imperfectly 
closes the outer orifice of the vagina in the virgin. It usually, 
when of a semi-lunar shape, occupies the lower or posterior por- 
tion of the canal, leaving an opening in the upper or anterior 
portion varying from the size of a quill to that of a thimble, 
through which the menstrual fluid exudes. This membrane is 
usually ruptured and destroyed by the first sexual intercourse, 
and hence its presence has been considered evidence of virginity. 
Its absence, however, must not be considered as conclusive evi- 
dence of sexual intercourse, for, as Dr. Robley Dunglison says, 
“ many circumstances of an innocent character may occasion a 
rupture or destruction of this membrane. It is often absent in 
children soon after birth; while it may remain entire after copu- 
lation. Hence the presence of the hymen does not absolutely 
prove virginity; nor does its absence prove incontinence, although 
its presence would be prima facie evidence of continence.” 
1589. Sometimes this membrane, when not imperforate, is so 
thick and strong as to render sexual intercourse impossible, and 
requires a cutting operation to open the vagina. Several such 
cases have been operated upon at the World’s Dispensary. 
1590. It occasionally happens that the hymen is entire, or 
imperforate, at birth. This may not be discovered before 
puberty. But when this period arrives and the menstrual dis- 
charge takes place into the vagina, the female will suffer from 
retention and accumulation of this secretion, and ultimately a 
tumor or a protrusion of the membrane which closes the vagina 
will occur, giving rise to severe pain and other serious symptoms. 
The retained menstrual fluid, increasing in quantity at every 
monthly period, dilates the womb as well as the vagina, and even 
the Fallopian tubes (see page 217) become distended, presenting 
at length an urgent necessity for relief. 714 
COMMON SENSE MEDICAL ADVISER. 
1591. Treatment. This condition admits of relief only 
by operative surgery. The operation consists in dividing the 
hymen by a crucial incision thus allowing the accumulated fluid 
to be discharged, after which the vagina is cleansed by syringing 
it with warm water. 
1592. Absence of the Ovaries. Let us suppose 
the case of a young woman who has fully reached the period 
of puberty without having menstruated. All the organs which 
we have described are manifestly developed, she is healthy, 
vigorous, robust and able to exercise freely or engage in 
laborious occupations. But we notice that her voice is not 
sweetly feminine, nor her pi'esence timid, tender and winning; 
there is wanting that diffident sexual consciousness which gently 
wooes, and at the same time deferentially repels, and is intended 
to awaken interest, curiosity and desire. Considering also 
that she has never manifested any inclination to menstruate, 
we are irresistibly led to the conclusion that the ovaries are 
wanting; the delicate mustache upon the upper lip, the undevel- 
oped breasts, the coarse features and her taste for masculine 
pursuits, all concur in this diagnosis. Thus we account for the 
harshness of the voice, fitted for command rather than to express 
the mellow, persuasive cadences of love. Such a malformation 
cannot be remedied. 
1593. Retention and Suppression from Mor- 
bid Conditions Of the Blood. Non-appearance, as 
well as suppression of the menses, may result from an abnormal 
state of the blood. The first condition that demands our atten- 
tion under this head is Plethora. In robust, plethoric females 
the menses are sometimes very tardy in their appearance, and 
every month the attempt to establish this function is attended 
with pain in the head, loins and back, chilliness, stomach sick- 
ness and bloating of the abdomen. Sometimes there is intoler- 
ance of light, or sound, and cerebral congestion amounting 
almost to apoplectic symptoms. The pulse is full and strong, 
the blood abundant and surcharged with red corpuscles. Such 
persons may be accustomed to luxurious living and there is evi- 
dently a predisposition to abnormal activity of the alimentary 
functions. 
1594. Treatment, I may briefly suggest that the AMENORRHCEA. 
715 
hygienic requirements are, first, to engage in laborious physical 
exercise in order to expend the surplus of vitality, and second, 
to lessen the daily amount of food taken and use that which is 
light and unstimulating. We must also obviate the determin- 
ation of blood to the head, by keeping it cool and the feet warm 
and establishing the flow of blood to the extremities. The 
volume of the circulation may be diminished by acting upon 
the natural outlets, as the skin, kidneys and bowels. The proper 
means and appliances for quickening the circulation of the blood 
are indicated, and friction upon the surface, bathing, the daily 
use of such active cathartics as my Purgative Pellets, and, 
finally, the use of some genial uterine stimulant, such as my 
Favorite Prescription, will generally prove successful in cases 
of amenorrhoea, resulting from plethora. 
1595. Retention and Suppression from An- 
aemia. To describe the condition of the patient whose blood 
is low and robbed of the richness, warmth and bloom it once 
possessed when it kindled admiration and enthusiasm in others, 
is hut to give a pen-picture of a numerous class of female inva- 
lids. It is sad to see beauty fading, vigor waning, and Bright’s 
disease or wan consumption slowly wasting the blood and con- 
suming the vital cells until the spirit can no longer dwell in its 
earthly abode and death claims the skeleton for dust. 
1596. Chronic Decline, with its attendant anaemia (f m), 
may be induced by bad habits, destitution, or constitutional 
depravity. Sickly forms, wrecks of health, matriculates of 
disease and candidates for the graduation which death honors, 
address our senses on every side. All these subjects evidently 
once had a capital in life, sufficient (if properly and carefully 
husbanded) to comfortably afford them vital stamina and length 
of days. Alas! they have squandered their estate, perchance in 
idleness and luxurious living, or have wasted it in vanities and 
misdirected ambition. Having become bankrupts in health, 
there is necessarily a failure of the menstrual function, and then 
follows a panic. All the blame of the insolvency and general 
derangement, is unjustly attributed to the non-performance of the 
duties of the uterus. Thus this organ is altogether dependent 
upon the general health for its functional ability, yet oftentimes 
treatment is instituted to compel menstruation, regardless of the 716 
COMMON SENSE MEDICAL ADVISER. 
condition of the system. Thus the enfeebled uterus is wrong- 
fully held responsible for general disorder, because it ceases to 
act, when by acting it would further deplete the blood and thus 
materially contribute to the already existing chronic decline. 
1597. No matter what are the causes of this decline, whether 
they he the follies of fashion, the effect of indolence, debility in 
consequence of insufficient food, perversion of nutrition by 
irregular habits, lack of exercise, or taking drastic medicines, 
the result is anaemia and amenorrhoea. Ah, in what enervating 
habits do many indulge! Let us describe a type of this class. 
1598. The patient is an only daughter, the idol of her pai’ents, 
who, in mistaken kindness, have stimulated her with every facil- 
ity for mental improvement and graceful accomplishments. Her 
physical powers are exhausted by mental effort; she becomes 
pale and feeble, discouraged and heart-weary, and finds a solace 
in the old arm-chair which now rocks in rhythm with her own 
sluggish feelings. Hicli food does not excite the appetite, but her 
disordered stomach loathes it. She has lost relish for intellectual 
efforts and enjoys the sensation of a yellow-covered pamphlet of 
fiction. The effort to entertain company only exhausts, and she 
thinks she is rather too delicate to ride out. She does not like 
to incur the risk of exposure to the open air. Mamma is afraid 
she might get cold, and eventually become a consumptive. 
Indeed, she “must have a physician right away.” So the doctor 
comes. Let us suppose that this incident transpired thirty 
years ago, when there was a popular way of doctoring, although 
there are many fossilized physicians even at the present day, who 
advocate and practice the same old theories which were exploded 
more than a quarter of a century ago. 
1599. The family attendant was an educated physician,whose 
practice, secundem artem, included the judicious employment of 
calomel, blisters and the lancet, which were regarded as indis- 
pensable to success. His arrival at the mansion was duly 
welcomed; with professional dignity he ti*eads lightly the Brus- 
sels carpet and encounters the old arm-chair and its invalid 
occupant. Ho carefully investigates the case; ascertains that 
there is constipation, a feeble pulse, languor of the circulation, 
general debility and suppression. He advises with respect to 
the diet, hopes that the patient will soon get about, leaves a few AMENORRHCEA. 
717 
Sedlitz powders, several blue pills, an emmenagogue elixir, rails 
against quackery, refers to recent social events, dilates upon 
scientific discovery, and his presence and agreeable conversation 
serve as a pleasant reminiscence for our patient. His visits are 
repeated, medicines varied and the patient continues to decline. 
1600. Rational Treatment. Let us leave behind 
the past and its shadows, and listen to the advice of modem 
science, which suggests more nutritious food, increased exercise, 
cleanliness, regular habits, hard beds and useful employment. 
The diet may be improved by animal broths, roasted meats, fresh 
beef, mutton, chicken or eggs, and the dress should be comfort- 
able, warm and permit freedom of motion. The patient should 
indulge in amusing exercises, walking, swinging, riding, games 
of battledoor or croquet, traveling, singing, percussing the ex- 
panded chest or engage in healthful calisthenic exercises, (see 
the article on physical culture in this volume). The hygienic 
treatment of this form of amenorrhcea then consists in physical 
culture, the regular use of appropriate baths, and the regulation 
of the bowels, if costive, as suggested in this volume under the 
head of constipation. 
The medical treatment should look to enriching the blood, 
improving nutrition, toning the generative organs and building 
up the health of the whole system. This requires the employ- 
ment of uterine and general tonics and my Favorite Prescrip- 
tion, which is sold by druggists, happily combines the properties 
required. It improves digestion, enriches the blood, exercises a 
tonic and gently stimulating effect upon the uterus and ovaries, 
and thus promotes the function of menstruation. It is not a 
strong emmenagogue (*f 574), but operates slowly, yet surely, 
and in accordance with physiological laws, being eminently con- 
genial in its effects upon the female system, and hence not 
liable to do harm. There is danger in employing active driving 
medicines, besides, no emmenagogue, however powerful, can 
establish the menstrual function so long as the system is in a 
debilitated condition and the blood be reduced. We must first 
secure the restorative effects of the Favorite Prescription by 
administering it regularly, in from one to two teaspoonful doses, 
three or four times a day for several weeks, and as the system is 
built up and those symptoms appear which indicate a return 718 
COMMON SENSE MEDICAL ADVISEE. 
of the menses, their visitation may be encouraged by the use of 
hot foot and sitz-baths and free doses of my Compound Extract 
of Smart-Weed. But the latter should only be used when 
symptoms of approaching menstruation are manifested. By 
following out this rational course of treatment, a soft flush will 
gradually take the place of the pallor of the cheeks, the appetite 
will return, the flesh come to drive away the ghost of the former 
self, sweet sleep to restore the body, while happy hopes will fill 
the mind with encouraging prospects, and the joyous life will 
gush out in social songs or scintilate in sparkling thoughts. 
1601. Acute Suppression of the Menses may 
be caused by vivid emotions, as excessive joy, or by violent 
excitement of the propensities, as intense anger, sudden fright, 
fear, anxiety, etc. Suppression may result fi’om sudden exposure 
to cold, immersion of the hands and feet in cold water, drinking 
cold water when the body is heated, sitting on the cold ground 
or damp grass, or from a burn or wound. It is not uncommon 
for women to labor in the heated wash-room, pounding, rubbing 
and wringing soiled linen, thereby overtaxing the delicate phy- 
sical system, which has been compared to a “ harp of a thousand 
strings,” attuned most perfectly to all the harmonies of health. 
While feeling tired and jaded, all reeking in perspiration, they 
rinse and wring the clothes out of cold water, and hang them 
upon the line with arms bare, when the atmosphere is so freezing 
that the garments stiffen before they finish this part of the task. 
Is it any wonder that acute suppressions occur or that inflamma- 
tions set in. 
1602. The symptoms that naturally follow are quick pulse, 
hot skin, thirst, fever, headache, dizziness, and the inflammation 
may locate in the ovaries, uterus, lungs, bowels, brain or other 
parts. No matter what organs are attacked the menses are sup- 
pressed. The suppression can generally be attributed to an 
adequate cause, resulting in constitutional disturbance. The 
severity and duration of the attack and the power of the consti- 
tution to resist it, must determine the gravity of the conse- 
quences. 
1603. Treatment. As acute suppression of the menses is 
due to derangement of the circulation of the blood, caused by tak- 
ing cold, by violent excitement of the propensities or excessively DYSMENORBIICEA. 
719 
vivid emotional experience, the prominent indication is to secure 
its speedy equalization. Give a hot foot, a warm sitz, or the 
spirit vapor-bath and administer full doses of my Compound 
Extract of Smart-Weed, to produce free perspiration. Dr. 
Eberle, a veiy celebrated medical author says, that he used th 
Extract of Smart-Weed in twenty cases of Amenorrhoea, and 
affirms that “ with no other remedy or mode of treatment have I 
been so successful as with this.” My experience in the use of 
my Extract has been equally satisfactory. Should this treatment 
not promptly establish the function, my Favorite Prescription 
should be given three times a day until the system is invigorated, 
say for twenty-eight days, when the above course may be 
repeated and will generally succeed. Should the case be com- 
plicated with inflammation of the lungs, brain or other vital 
organs, manifesting alarming symptoms, the family physician 
should be called. The treatment must be active and suited to 
the indications of each particular case. When the disease 
becomes chronic, the active stage of symptoms having passed, 
and it continues to linger without making the desired improve- 
ment, all the means suggested for the treatment of suppression 
from anaemia should be employed and will be followed by the 
most gratifying results. It should be borne in mind however, 
when I have suggested any treatment in this volume, it is gener- 
ally such as the family may institute, and does not by any means 
represent the variety or extent of the remedial resources which I 
employ when consulted in person or by letter. I refer my readers 
to only a few of the safe and reliable remedies which I have pre- 
pared and placed within their reach, and give them just such 
hygienic advice as I think will best subserve their interests. 
DYSMENORRIICEA. (Painful Menstrution.) 
1604. Dysmenorrhoea, from, its Greek derivation, signifies 
difficult monthly flow, and is applied to menstruation when 
that function becomes painful and difficult. Menstruation, 
like other healthy operations of the body, should be painless, 
but too frequently it is the case, that discomfort and distress 
commence twenty-four hours before the catamenia appears, 
and continue with increasing pain, sickness at the stomach, and 
vomiting, until the patient has to take to the bed. When 720 
COMMON SENSE MEDICAL ADVISER. 
the discharge does occur, instantaneous relief is sometimes ob- 
tained and the patient suffers no more during that menstrual 
period. With others, the commencement of the function is- 
painless, but from six to twenty-four hours after, the flow is 
arrested and the patient then experiences acute suffering. Pain 
may then be felt in the back, loins and down the thighs. Some- 
times it is of a lancinating, neuralgic kind, at others, it is more 
like colic. Frequently the distress causes lassitude, fever, gen- 
eral uneasiness and a sense of lethargy. There are those who 
suffer more or less during the entire time of the flow, while the 
distress of others terminates at the time when a membranous 
cast is expelled. For convenience of description, dysmenorrhoea 
has been divided into the following varieties, viz: Neuralgic, 
Congestive, Inflammatory, Membranous and Obstructive. 
1605. The neuralgic variety of dysmenorrhoea, sometimes 
also called spasmodic or idiopathic, occurs (1), where there is 
excessive sensibility of the ovaries and uterine nerves, which 
sympathetically respond, especially to cutaneous, biliary and sex- 
ual irritation, and (2) when ovarian or uterine irritation is com- 
municated to distant nerve centres, as, for example, the stomach 
or brain. In the first class, comprising usually lean persons of 
an encephalic temperament, whatever disorders the functions of 
the general system, instantaneously reflects upon the ovaries and 
uterine nerves, and the menstrual function is correspondingly 
disturbed, and instead of a painless flow, it becomes spasmodic, 
paroxysmal and distressing. In the second class, which includes 
those who are plethoric in their tendencies, the ovarian and 
uterine nerves seem themselves to be the origin and centre of 
irritation, causing indescribable pain. The agony may be so 
severe as to be almost intolerable, and I have seen some women 
who affirmed that the severity of labor pains was not as great as 
that from this cause. Mrs. T., for eleven years, suffered thus, and 
then became a mother, and has ever asserted that her periodic 
suffering was far more intense than the pain experienced during 
her confinement. These neuralgic pains fly upon the tractus of 
nerves to different organs, and capriciously dart from point to 
point with marvelous celerity, producing nausea, headache and 
delirium. I remember being called several years ago to see 
a Miss G., whom I found writhing in intense agony, rolling Plate IV. 
Fxg.22 
Fig. 21. 
Fig. 24 
Fig. 23 
Fig. 25 
Fig. 26 DTSMEN ORRHCEA. 
721 
about on the bed in a delirium of pain, insensible to everything 
but her excruciating torment. I immediately gave her a strong- 
anodyne sedative and left. In thirty minutes, I was told, she 
partially aroused from her semi-delirious condition and very 
curtly inquired, “ Where’s the doctor ? ” “ Gone,” was the 
laconic reply, when she instantly and gratefully responded, “ I 
could kiss his foot! ” When relief from such terrible neuralgic 
torture is experienced, we may allow sufficient latitude for a 
thankful expression. 
1606. Ill the congestive variety of dysmenorrhoea 
the menstrual period may be ushered in without pain; after a 
few hours the pulse becomes stronger and more rapid, the skin 
grows hot and dry, the menses stop, thei'e is uneasiness, restless- 
ness and severe pelvic pains. Evidently the mucous membranes 
of the Fallopian tubes and uterus have become congested and the 
pain results from the arrest of the functional process—the exu- 
dation of blood. 
1607. The Causes are plethora, exposure to cold, excite- 
ment of the emotions or passions, morbid condition of the blood, 
and sometimes congestion arises in consequence of displacement 
of the uterus. 
1608. In the inflammatory variety the mucous 
membrane of the uterus seems to be the seat of irritation. The 
blood flows into the capillary vessels in greater abundance than 
is natural, and those vessels become overdilated and enfeebled, 
and so altered in their sensibility as to produce local excite- 
ment and pain. It may be associated with inflammation of the 
ovaries, peritoneum or bladder. Upon the return of the menses, 
there is a dull, heavy, fixed pain in the pelvis, and it continues 
until the period is completed. There is generally tenderness of 
the uterus, and also leucorrhcea, during the intervals between 
each monthly flow. 
1609. In the membranous variety of dysmenor- 
rhcea, the entire mucous membrane, which lines the cavity of 
the uterus, in consequence of some morbid process, is gradually 
detached and expelled at the menstrual period. 
1610. Symptoms. There are steady pains at the com- 
mencement of the menstrual flow, but they increase in violence 
and become decidedly expulsive. The mouth of the uterus 722 
COMAION SENSE MEDICAL ADVISER. 
gradually dilates and finally the membrane is foi-ced out of the 
uterus, attended with a slight Aoav of blood and entire subsidence 
of the pain. 
1611. The treatment in all the preceding varieties of 
dysmenorrhcea should be directed to determine the circulation of 
the blood to the surface and increase the perspiratory functions. 
Congestion and inflammation of the internal organs are gener- 
ally induced by exposure to cold or from insufficient clothing. 
Sometimes they follow from neglect of the skin which is not 
kept clean and its excretory function not encouraged by warm 
clothing. The domestic treatment at the monthly crisis should 
be commenced by the administration of hot foot, and sitz-baths, 
after which the patient should be warmly covered in bed and 
bottles of hot water applied to the extremities, back and 
thighs. My Compound Extract of Smart-Weed should be given 
in full doses frequently repeated, to secure its diaphoretic, em- 
menagogue and anodyne effects, which, in this painful affection, 
are unsurpassed. For the radical cure of this disease, whether 
of a congestive, inflammatory or neuralgic character, my Favor- 
ite Prescription, which is sold by druggists, is a pleasant and 
specific remedy that will most speedily correct the abnormal 
condition that produces the trouble, and thereby obviate the 
necessity of passing this terrible ordeal at each monthly period. 
The patient should take tAvo teaspoonfuls of the medicine three 
times a day and keep up its use in these doses for weeks. Many 
times one month will suffice to cure, but in most cases a longer 
season is required. In the end the suffering patient will not 
be disappointed, but will become a new being, ready fox- 
life, its enjoyments and duties. The boAvels must be kept 
regular throughout the treatment by the use of my Purgative 
Pellets, if necessary. A hand, or sponge-bath should be used 
daily to keep the skin active, and folloAved with brisk rubbing of 
the surface Avith a rough towel or flesh-brush. A wet sheet 
pack (see Avill unburthen the pores of the skin and invite 
the blood into the minute capillaries of the surface and thus prove 
of great benefit. It should be repeated after an interval of seven 
days, but must be omitted if near the approach of a menstrual 
period. The clothing must be warm, to protect the system from 
temperamental changes; especially should every precaution be DYSME^TORRHCEA. 
723 
taken to keep the feet dry and warm, (see 433). The patient 
should take exercise in the open air by walking, and the dis- 
tance should be lengthened regularly at each succeeding walk, 
as the strength is increased. If the treatment which I have sug- 
gested be perseveringly carried out, good and permanent effects 
cannot fail to be produced. 
1612. Ill the obstructive variety of dysmenorrhoea, 
some organic impediment hinders the exit of the menstrual 
blood from the uterus, which consequently becomes distended 
and painful. The distress may be continual, but is most acute 
when the uterus makes spasmodic efforts to discharge the men- 
strual blood. If these efforts prove successful, there is an 
interval of relief. 
1613. Under amenorrhcea I alluded to the complete closure 
of the mouth of the uterus which thus prevents the appearance 
of the menses. I shall now consider the contraction or congen- 
ital narrowing of the vagina and neck of the uterus, and 
explain how it obstructs the flow until the efforts to overcome 
the obstacle, although painful, are in a measure successful. 
Partial adhesion of the vaginal walls or those of the neck of 
the womb may result from inflammation of the mucous lining 
and prevent a free and easy exit of the menstrual fluid. 
1614. Treatment. In some cases, a cure may be effected 
by repeated endeavors to dilate the passage and thus overcome 
its constriction. This may be accomplished by using a very 
smooth probe which is fine at the point, but increases in size, so 
that its introduction will widen and expand the orifice and canal. 
In many cases, by using different sized probes, the stricture will 
be overcome. 
1615. In some instances, other expanding instruments are 
employed, or a tent may be introduced and allowed to remain 
for twenty-four hours and then changed for another. If there 
seems to be a persistent disposition of the circular fibres of the 
neck of the uterus to contract, and thus close the canal, an ope- 
ration will be necessary to give permanent relief. The operation 
which is resorted to in such cases, consists in introducing through 
the neck of the womb an instrument called the hysterotome, 
which is no larger than a moderate sized probe, or silver catheter, 
and by turning a screw on the end of the handle two small COMMON SENSE MEDICAL ADVISER. 
blades are thrown out, and then the instrument is withdrawn, 
making an incision on either side of the canal. After its 
removal a tent of compressed sponge may be introduced. The 
tent is changed every day and the treatment continued for two 
weeks. The operation affords immediate relief and a permanent 
cure is thereby obtained. 
MENORRHAGIA. (Profuse Menstruation.) 
1616. The word Menorrhagia, which is of Greek derivation, 
literally means monthly breaking away, and is employed to 
designate profuse menstruation. This disorder must not be 
confounded with uterine hemorrhage, which is not periodical, 
and is due to other causes. The term Menorrhagia is therefore 
restricted to an immoderate monthly flow. The menstrual flow 
may be immoderate by occurring too often, continuing too long, 
or by being too profuse. It induces a feeble pulse, cold extrem- 
ities, weak respiration, general debility, and may occur in 
opposite states of the system; i. e., with the plethoric and robust, 
or with those of flaccid muscles and bloodless features. When 
the menstrual discharge is natural, it is so gradual that by mix- 
ing with the vaginal secretions, it is prevented from coagulating, 
while in this disease, many times clots are observed. 
1617. 8yinptoill$. In those of a plethoric habit, it is 
ushered in with itching and heat in the vagina, pain and a feeling 
of weight in the loins and lower part of the abdomen, and at 
times the breasts become hot and painful. There is considerable 
thirst, headache and giddiness. At last, the blood appears and 
flows profusely, and all the violent symptoms at once subside. 
The rest of the period is passed with an inordinate flow, leaving 
the system weak from loss of blood. It is, however, of more 
frequent occurrence where the second condition prevails; that is, 
with the naturally weak and delicate, in which case the periods 
occur oftener and continue longer, and after a time they are 
renewed by any bodily exertion or mental emotion, so that a 
constant drain may exist. If the flow of blood does not continue 
all the time, leucorrhoea intervenes. The patient gradually loses 
strength and becomes languid, her face is pale, usually bloated, 
livid circles appear around the eyes, the appetite is impaired, the 
bowels constipated, and the feet and ankles swollen. Lack of MENORRHAGIA. 
725 
blood in the brain is indicated by headache, ringing in the ears, 
and dizziness. She is nervous and irritable, being disturbed by 
the slightest noise, and the heart palpitates on the least exertion. 
1618. Causes. The first form is caused by over-eating, 
rich and highly-seasoned food, drinking wine, porter, ale and 
beer, want of exercise, and whatever else induces plethora; 
the second, by insufficient or poor diet, leucorrhoea, frequent 
abortions, want of ventilation, inherent feebleness, and whatever 
else depresses the vital powers. Either form may be caused by 
syphilitic taints, excessive sexual indulgence, accidents of preg- 
nancy, and organic diseases of the womb. The oi’ganic affections 
of the womb most likely to cause menorrhagia, are granular 
ulceration of its mouth and neck, fungous degeneration of its 
lining membrane, and tumors within that organ. As these sub- 
jects will be severally considered hereafter, I will dismiss them 
here with this simple mention. 
1619. Profuse menstruation is very prone to occur in young 
women of a lymphatic temperament, with whom all the organs 
are sleazy in their texture, destitute of constructive energy and 
cohesive properties. The blood is not so highly organized as in 
the vital temperaments, consequently it is more lymph-like, and 
the more readily exudes through the membranes. 
1620. Treatment. To control the excessive flow, for 
the time being, the patient should take to her bed, and keep the 
recumbent position until the period is passed. If circumstances 
do not permit of this rule being strictly complied with, it should 
be observed as nearly as possible. Warmth may be applied to 
the feet, and cold cloths, which must be removed as soon as they 
become warmed by the heat of the body, should be repeatedly 
placed upon the back and abdomen. A strong tea made from 
cinnamon bark, or witch-hazel 518), leaves or bark, taken 
freely, will prove very efficacious in checking the flow. An- 
other valuable remedy in arresting uterine hemorrhage is an 
infusion of Canada fieabane 522), or the oil of this plant may 
be administered in from five to ten drop doses, on sugar. Gallic 
acid 524) is also a good styptic to employ in these cases. 
Where there is febrile excitement, pulse hard, frequent and 
throbbing, and where there is headache, thirst, lips parched, 
skin hot and dry, as is frequently the case in the sanguine COMMON SENSE MEDICAL ADVISER. 
temperament, then menorrhagia may be due to an increased 
action of the heart and arteries, and the indication of treatment 
is to diminish vascular action generally. This may be temporarily 
accomplished by the use of veratrum 597), which should be 
repeated until the flow is sufficiently diminished. 
1621. The means already suggested will generally prove 
effective in controlling the inordinate flow, at the time, and we 
must now adopt treatment that will produce permanent results 
ancl prevent a return of the disturbance. The condition of the 
skin, kidneys and bowels requires attention, and noxious ele- 
ments should not be retained in the system. To give tone to the 
weakened organ—the womb—I know of nothing more specific 
in its effects than my Favorite Prescription, which is sold by 
druggists. It should be taken continuously, for weeks, in order 
to fully correct the weakened condition which this organ has 
been so long in assuming. It also aids nutrition, and by so doing 
tones the general system, so that in the form of profuse men- 
struation accompanying the debilitated, the patient is being built 
up, her blood enriched and her nervousness quieted at the same 
time, which constitutes the necessary treatment to make the cure 
permanent. 
1622. As women approach the critical age, and the function 
of menstruation ceases, if they be anaemic, their condition is 
pitiable. This period is popularly denominated the turn of life. 
Under favorable circumstances, the vitality is decidedly enhanced 
and the decline of this function is attended with a revival of the 
bodily powers. But when this crisis has been anticipated by ex- 
cessive labor resulting from inordinate ambition, when intemper- 
ance or excesses of any kind have deranged the bodily functions 
or perverted nutrition, when the mind has been long and deeply 
depressed, or when the insidious progress of disease of the heart, 
liver and other important organs occurs in consequence of irreg- 
ularities of living, then there is danger of congestion of the 
uterus and a protracted and profuse menstrual flow, which favors 
a decline. 
1623. The treatment of this form of menorrhagia does not 
differ from that already suggested. The diet should be light and 
nourishing, and daily exercise, walking, riding, change of air and 
scenery, all may contribute to restoration. Especial attention TURN OF LIFE. 
727 
should be directed to the condition of the bowels and liver, 
and if the latter be deranged, my Golden Medical Discovery 
may be employed with decided advantage. When there is 
diminution of life-force which results in impairment of nutrition 
and disorders of the blood, then an alterative is required which 
will insensibly and gradually restore activity by removing the 
causes of derangement. Impairment of nutrition is very fre- 
quently associated with or organic disease of the 
liver, and curative measures consist of friction, baths, exercise, 
nutritive diet, diversion of the mind, etc., with alterative reme- 
dies. Whenever the fault of innutrition depends upon deprava- 
tion of the blood or torpor of any of the secretory organs, my 
Golden Medical Discovery will prove to be an invaluable reme- 
dial agent, for it is an alterative and at the same time a blood 
restorative. It may be used in connection with my Favorite 
Prescription, which tends to regulate the uterine function by 
toning the fibres of the mucous membrane and restraining the 
escape of the menstrual fluid from the orifices of the blood- 
vessels. While the diet should be nourishing and may consist 
partially of wild game, mutton, chicken, wine, etc., the patient 
must be very careful and not debilitate the stomach by the use 
of strong tea or coffee. The circulation of the blood must be 
improved by riding, walking, exposure to sunlight and fresh air. 
If the patient be able, she ought, by all means, to engage in 
some light occupation, in which the mind will be constantly as 
well as agreeably employed, but not overtaxed. In this way 
invalids suffering from menorrhagia may be permanently restored 
to health and usefulness. 
1624. The menstrual function commonly occurs in the human 
female at regular monthly intervals during a period of about 
thirty years. The time for its cessation depends somewhat upon 
the date of its first appearance. In the temperate zones, the 
catamenial function commences at about the fifteenth year, and 
consequently should terminate at the forty-fifth year. Instances, 
however, are common where this function has been prolonged 
until the fiftieth and even the fifty-fifth year. In warm climates, 
it commences and terminates at an earlier age. 
THE TURN OF LIFE. (Cessation of the Menses.) 728 
COMMON SENSE MEDICAL ADVISER. 
1625. As women approach the critical period of life, if the 
general health and habits be good, the 'discharge may gradually 
diminish, and at length totally disappear, without producing any 
particular inconvenience; but this seldom happens. It is more 
customary for the discharge to be entirely absent for six or seven 
weeks, and when it does return, it is more copious than usual. 
In some cases the flow is not only too profuse, but too frequent; 
afterward there may follow an interval of months, when it is 
altogether absent, and when it returns, it is very pale and defi- 
cient in quantity. 
1626. The fluctuations of this function occasion irregularities 
and disturbances of the general health. When the fluxion of 
blood is diverted from the uterus, it is liable to be directed to 
the head or some other part of the body. In fact, there appears 
to be constitutional agitation, and disorders of all the organs. 
Perhaps one reason for calling this a critical period is, that if 
there be a morbid tendency in the system—a disposition to 
develop tumors of the breast or uterus—these are very liable 
to make rapid progress at this time, since they are not relieved 
by the customary local exudation of blood. It is a time favorable 
to the awakening of latent disorder and morbid growths, for with 
the decline of the menstrual function, the uterus is not as capa- 
ble of resisting vitiating influences. 
1627. There is greater liability to irritation of the bladder 
and rectum, and the uterine flow may be superseded by a white 
acrid discharge, in consequence of inflammation of the mucous 
membrane of the vagina. So that if the system be not enfeebled 
under excessive losses of blood, debility may follow from con- 
tinued irritation of the uterine organs, resulting in morbid 
discharges consequent upon such chronic inflammation. The 
nervous system sympathetically responds, becoming exceedingly 
sensitive and irritable, and thus implicating in this disorder every 
bodily function. In some constitutions, the change of any habit 
is almost impossible, particularly if it be improperly acquired, or 
detrimental to health: and so I have sometimes thought re- 
specting this function, that the more it has been abused and 
perverted during the time of its natural activity, the greater the 
constitutional disturbance it occasions vdien it ceases. 
1628. Treatment. Proper hygienic management enjoins TURX OF LIFE. 
729 
regularity in all the habits of life. Women are too apt to 
neglect themselves, and approach this important period without 
due care and consideration. When the physical system is about 
to suspend a complimental function, and at the same time mod- 
erate its own activity, it is worse than folly to be instigated by 
ambition and endeavor to perform the labor or assume the 
responsibilities which were once allowable, when the constitution 
was more robust. 
1629. How do the necessary duties of each day and hour 
weigh upon the energies of the mother, and what intense solici- 
tude and yearning of soul she experiences, what prayers does 
she offer to the loving Father of all children that He may safely 
guide and bless her own! How unselfish is that mother, who 
each day works steadily and faithfully for others, feeling her 
accountability and dependence, and conscious also of the hidden 
dangers that lurk all along the pathway of life ! With beautiful 
faith and love, she commends the interests of her children to 
Him who doeth all things well. She continually anticipates the 
wants of the family and strives to supply desired comforts, thus 
wasting her strength in the labors that flow from her loving 
nature. Would it not be a greater comfort to those children to 
have the counsel and guidance of their dear mother, than to 
undergo the bitter reflection that she sacrificed her health and 
life for their gratification ? 
1630. Unconsciously, perhaps, but none the less certainly, do 
women enter upon this period, regardless of the care they ought 
to bestow upon themselves. Without sufficient forethought or 
understanding of the functional changes taking place, they inade- 
quately economize their strength, until by continuous exertions 
they break down under those labors, which, simply by reason of 
their age, are excessive and injurious. Is it any wonder, when 
thus worn out by service, the body trembling with fatigue, the 
mind agitated with responsibilities, that the menses capriciously 
return or the uterus is unable to withstand congestion and that 
capillary hemorrhage becomes excessive ? Whereas, if the physi- 
cal system had not thus been exhausted, it would have exercised 
its powers as so many nerve forces for the conservation of health 
and strength. It is better to be forewarned of the evils to which 
we are liable, and fortify ourselves against them, rather than 730 
COMMON SENSE MEDICAL ADVISER. 
squander the strength intended for personal preservation. Let 
every woman, therefore, and especially every mother, consider 
her situation and surroundings, properly anticipate and rightfully 
prepare for that grand climacteric, which so materially influences 
the future of health and life. 
1631. The general health should be carefully maintained and 
preserved by those exercises which will equalize the circulation 
of the blood, and the regular action of the bowels should be 
promoted by the use of those articles of diet which contribute 
to this end; relieve the mind of responsibility, keep the skin 
clean and enrich the blood with tonics and alteratives. For the 
latter purpose use my Favorite Prescription and Golden Medical 
Discovery. If these remedies fail, it will be proper to obtain pro- 
fessional advice. A careful regulation of the daily habits, strict 
attention to the requirements of the system and the use of tonic 
medicines, will very frequently render entirely unnecessary the 
employment of a physician. 
LEUCORRIICEA. (Whites.) 
1632. Leucorrhcea is the symptomatic manifestation of some 
uterine or vaginal affection, vulgarly called “ whites.” I say 
symptomatic, for the white or yellowish discharge, which we 
term leucorrhcea, is not a disease, hut a symptom of some uter- 
ine or vaginal disordei\ We call it a white discharge to distin- 
guish it from the menses and uterine hemorrhages. It varies, 
however, in color and consistency from a white glairy mucus to 
a yellow or greenish purulent, foetid matter. Sometimes it has a 
curdled appearance, at others it is of the consistency of cream. 
Leucorrhcea is the most common symptom of uterine disorder, 
and there are few females who are not affected by it at some 
period of life. It may originate either in the vagina or uterus, 
and accordingly it is termed vaginal or uterine leucorrhcea. The 
nature of leucorrhcea is analogous to that of nasal catarrh. In 
a healthy state the lining membrane of the genital organs 
secretes sufficient mucus to render them moist; but if the 
mucous membrane becomes temporarily congested or inflamed, 
the secretion is profuse, irritating and offensive. Vaginal and 
uterine leucorrhcea are essentially different in the character of 
the discharge, the former being an acid and the latter an alkaline LEUCORRHCEA. 
731 
secretion and while the first is a creamy purulent fluid, the latter 
is thick and ropy like the white of an egg. In fact the latter 
discharge is rich in albuminous matter and blood corpuscles, 
hence its great debilitating effect upon the system, and if not 
promptly arrested it is likely to produce Vaginitis, Pruritus 
Vulvce or Vulvitis. 
1633. (1.) Vaginitis is indicated by intense inflammatory 
action in the mucous membrane of the vagina. When this affec- 
tion is present the patient will experience a sense of burning heat, 
aching and weight in the region of the vagina, violent throbdbing 
pains in the pelvis and the discharge will be profuse and very 
offensive. There will also be a frequent desire to urinate, and 
the passage of the urine will cause a sensation of scalding. 
1634. (2.) Pruritus Vulvce. The discharge irritates the nerves 
of the external genital parts, thus producing an almost unendur- 
able itching. Scratching or rubbing the parts only aggravates 
the affection. The patient is tormented night and day, is deprived 
of sleep and naturally becomes despondent. Pruritus vulvse in 
its severest forms is often developed when the discharge is 
scarcely noticeable. It is the most common sequence or accom- 
paniment of leucorrhcea. 
1635. (3.) Vulvitis. This term indicates an inflammation of 
the lining membrane of the external genital parts. Sometimes 
the inflammation extends to the deeper tissues, causing great 
pain and even suppuration, resulting in the formation of an ab- 
scess. The attack is indicated by redness, swelling and a feverish 
state of the affected parts, which is quickly followed by a profuse 
flow of yellow pus (matter), and in some instances small ulcers 
(sores) are formed on the affected parts. 
1636. Symptoms. The sufferer with leucorrhcea gener- 
ally becomes pale and emaciated, the eyes are dull and wear a 
heavy look, the functions of the skin, stomach and bowels become 
deranged, the circulation is unequal, the feet are cold, more or 
less pain is apt to be experienced in the head, sometimes accom- 
panied with dizziness; palpitation is common, and as the disease 
progresses the blood becomes impoverished, the feet and ankles 
swollen, the mind is affected, apprehensive and melancholy, and 
very frequently the function of generation is injured, resulting in 
complete sterility. On exercising, pain is experienced in the small 732 
COMMON SENSE MEDICAL ADVISER. 
of the back and lower down the spine, and owing to a relaxation 
of the vaginal walls, the womb falls far below its natural position, 
or turns in various directions according as the weight above may 
rest upon it. Ulcers are apt to arise upon the mouth of the womb, 
the matter from which tinges the discharge and stains the linen. 
Hysteria is also many times an attendant upon this disease. 
1637. Causes. The immediate causes of leucorrhoea are 
either congestion or inflammation of the mucous membrane of 
the vagina or womb, or both. The exciting causes are numerous. 
Among others, deranged menstruation, prolonged nursing of 
children, pregnancy, abortions, excessive indulgence in sexual in- 
tercourse, want of cleanliness, piles, uterine ulcers and displace- 
ments of the womb are the most common. In brief, it usually 
accompanies every uterine disorder which tends to vitiate and 
reduce the system. In childhood, particularly with scrofulous 
children, discharges from the vagina are not unfrequent, owing 
to worms or other intestinal irritation. 
The most frequent organic causes of leucorrhoea are ulceration 
of the mouth or neck of the womb and tumors. These will be 
considered hereafter. 
1638. Treatment. I have dwelt somewhat lengthily 
upon leucorrhoea because of its prevalence and in order to ex- 
hibit the various forms it may assume. These reasons long ago 
prompted me to investigate it; and, ascertaining the derange- 
ment to consist in a relaxation of the walls of the vagina, at- 
tendant upon depressed vitality, for many years I experimented 
with various agencies to find those that would exercise specific 
properties in restoring the system and tissues involved to a 
natural, healthy condition, thereby arresting the abnormal dis- 
charge. My efforts in that direction have been fully successful, 
and my expectations more than realized. The treatment which 
I shall recommend is rational and based upon the pathological 
conditions of this disease and being adapted to them is attended 
with the greatest success. , 
It embraces the use of general restoratives and specific uterine 
tonics, which are happily and harmoniously combined in my 
Favorite Prescription, which has achieved unparalleled success 
in this disorder, and won the highest praise from thousands of 
grateful women. In many cases it is well to accompany its use LEUCOREHCEA. 
733 
with alterative treatment, which is furnished in my Golden 
Medical Discovery. It is an absurd practice to undertake to 
arrest the discharge by astringent injections alone. The weak 
and lax walls of the vagina, as well as of the other tissues of the 
system, require toning up, and this must be done with general 
and special tonics. Appropriate injections as auxiliary treatment 
will very much assist in the cure. My Favorite Prescription is 
a special tonic to the affected parts and my Golden Medical Dis- 
covery is the best general alterative of which I have any knowl- 
edge. They may be taken in alternate doses every day. If the 
patient be very anaemic (bloodless) and pale, one drachm of the 
carbonate, or two drachms of the citrate or pyrophosphate of 
iron may with advantage be added to each bottle of the Favorite 
Prescription. If the carbonate is employed, as it is insoluble, 
the bottle must be well shaken just before using of the medicine 
each time. The skin should be kept active by frequent baths, 
and the patient, if able, should take moderate exercise in the open 
air, either walking or riding, and expose herself freely to the sun- 
shine. If the invalid is too weak to exercise much, she should 
get out in warm weather and sit in the open air. Sunshine is 
not less important in maintaining animal, than in supporting 
vegetable growth and health. The human being, like the plant, 
sickens and grows pale, weak and tender if kept excluded from 
the rays of the sun. The apartments occupied should be thor- 
oughly ventilated. Many women are kept sickly and feeble by 
living in illy ventilated and overheated rooms. 
1639. I cannot too strongly urge in this, as in all other 
chronic diseases peculiar to women, that the bowels be kept 
regular. Frequent, small doses of my Pleasant Purgative 
Pellets, to fall short of active purging, will prove most bene- 
ficial. As a lotion, if the vaginal passage be tender and irri- 
table, an infusion of slippery-elm bark will be very soothing and 
may be used freely with a vaginal syringe. Whatever injection 
is employed it should be preceded by the free use of Castile soap 
and warm water, to thoroughly cleanse the parts. One part of 
glycerine to six of water makes a soothing lotion when there is 
much tenderness, heat and pain in the vagina. If there is no 
great tenderness in the vagina, or after the acute inflammatory 
symptoms have yielded to the lotions already suggested, then a 734 
COMMON SENSE MEDICAL ADVISEE. 
more tonic and astringent injection should be employed. An in- 
fusion of Peruvian bark, witch-hazel leaves or bark, or either of 
these combined with golden seal root, will make a very valuable 
lotion to be employed. A teaspoonful of tartaric acid in a pint 
of warm water, is a specific in some cases, acting like magic. Dr. 
Sage’s Catarrh Remedy liquid, is as much a specific in some cases 
of leucorrhoea as it is for nasal catarrh. To render it more as- 
tringent, however, a gill or two of oak bark tea, or of the infusion 
of Peruvian bark or witch-hazel, may be added to each pint of 
the liquid. This will improve its efficacy in cases where the dis- 
charge is very profuse and resists the simpler lotions. Whatever 
lotion is employed, always use it warm. 
1640. If Pruritus is a troublesome symptom, the itching will 
readily yield if the parts be cleansed with Castile or other fine 
soap and warm water, followed by the application of a compound 
composed of glycerine, two ounces, rose-water, one ounce, and 
sulphite (not sulphate) of soda, one drachm. Or, for the sulphite 
of soda, in this lotion, two drachms of borax may be substituted. 
The following lotion is a good one to relieve pruritus: take sugar 
of lead, two drachms, carbolic acid, half a drachm, laudanum, 
four ounces, glycerine, four ounces, water, four pints, mix. This 
may be applied to the itching parts and also injected into the 
vagina. 
1641. How to u§e Vaginal Injections. The value 
of vaginal injections depends very much upon the manner in 
which they ara applied. A large-sized glass, or hard rubber 
fema$Psyring$f<or, what is still better, a pump syringe (largest 
size), should* be employed. The advantage of the latter instru- 
ment is that the patient can use it conveniently without an 
assistant, and can use any amount of fluid required without hav- 
ing to remove and re-insert it. These injections should be used 
while lying down, the hips being well elevated on bolsters or 
pillows. After introducing the syringe, which should be pressed 
up as far as possible without causing pain, so as to bring the end 
of the tube in contact with the os uteri (or mouth of the womb, 
see illustration on page 217); the external parts should be firmly 
compressed around the instrument with a large napkin or towel; 
after which the fluid, which should not he less in quantity than 
two ounces, should be injected, and in this way held in contact STERILITY. 
735 
with the icalls of the vaginal canal for at least five minutes. If 
these precautions are not observed, the syringe not being intro- 
duced far enough, or being used in a standing or sitting posture, 
the injected fluid will immediately pass away, and will come in 
contact with, and act only upon, a small portion of the diseased 
parts—doing little or no good. Warm water should be plenti- 
fully used with the syringe, according to the above instructions, 
to cleanse the parts from all acrid, irritating and offensive ex- 
cretions, previous to making use of any medicated fluids. It 
is necessary to say that sexual intercourse must be entirely 
avoided when under treatment for diseases of the female 
genital organs, as it is generally impossible to effect a cure 
when this rule is not strictly observed. 
1642. The subject of sterility is a barren topic upon which 
to write. Real sentiment and interest centre in fecundity, since 
the desires and happiness of mankind are consummated in 
marriage and procreation. How dreary would life be without 
love, companionship and the family ! How precious are the ties 
that bind our hearts to father, mother, daughter and son, and 
how all kindred interests cluster around the institution of mar- 
riage ! The love of children is innate, and each child born sup- 
plements the lives of its parents with new interests, awakens 
tender concern and unites their sympathy with its young life, 
and thus the joys of childhood are re-experienced. 
STERILITY. (Barrenness.) 
1643. How dreary indeed is the thought that one may attain 
a ripe old age with neither son nor daughter to smooth the de- 
cline of life, or sorrow for his departure ! How many women 
desire a first-born of love—the idol of their waiting hearts—to 
welcome a soul, which shall be begotten within, clothed with 
their own nature, and endless in duration ! It is a natural instinct, 
this yearning of the heart after life, and yet little is said upon 
this subject, where so much is experienced. All that is beautiful 
and lovely in woman, finds its ultimatum in motherhood. And 
what earthly being do we love so devoutly as mother ? 
1644. Men and women exhibit but little concern, mere idle 
curiosity perhaps, in this subject, unless, perchance, there be no 
evidence of their own reproductive powers. If, however, these 736 
COMMON SENSE MEDICAL ADVISER. 
appear to be deficient, then few topics are more deeply interest- 
ing, or investigated with greater personal solicitude. Seldom it 
is that such persons will submit their condition to the opinion of 
the family physician, for it is a delicate subject involving per- 
sonal considerations, and therefore they prefer to consult with 
one who cannot connect their unfortunate situation with any of 
the occurrences which enter into the history of their lives. This 
is very natural and sometimes the only way to keep private mat- 
ters profoundly secret. As a consequence, and being known 
throughout the continent, and even in Europe and other parts of 
the world, as a specialist, devoting my individual attention to 
chronic affections, and therefore enjoying unusual facilities for 
the investigation and management of such cases, I have been 
consulted in almost innumerable instances, to ascertain the causes 
of barrenness and employ my skill for their removal. 
As impotence of the male will be treated in a succeeding part 
of this volume, I shall confine myself in this place to the consid- 
eration of sterility resulting from disorders or defects of the 
female system. 
It is admitted that the question of a woman’s being probably 
sterile, is practically decided in the first three years of married 
life, for statistics show that less than ten in a hundred, who do 
not indicate their fertility in the first three years of wedlock, 
ever bear children. And yet I have treated many who gave no 
evidence of fertility for a much longer period of married life, 
and afterwards gave birth to children. We are unable to give 
anything like a proper ratio of the number of the married who 
are childless, much less have we the right to assume that all 
those who decline the responsibilities of motherhood are neces- 
sarily barren. 
1645. From observations made in England, it is estimated 
that twenty families in a hundred, or nearly one-fiftli of those 
joined in the bonds of wedlock, are childless. I am satisfied that 
the most reliable statistics cannot indicate the absolute sterility 
of these families, for the reason that when a divorce has had the 
effect to annul the marriage tie, each one of the sterile parties 
previously united in wedlock, have, in their new conjugal rela- 
tions, become parents, conclusively proving the fruitfulness of 
both parties. Such facts indicate that there may have existed STERILITY. 
737 
unsuitableness of the organs of generation, inadaptation of tem- 
peraments, or incompatibility of constitution, between these 
parties, to disqualify them for reproduction (see page 182). 
They were only sterile with respect to each other, and fertile 
under more favorable alliances. 
1646. Caiise§. The causes that result in barrenness in the 
female may be malformation of the uterine organs; as, absence 
of the ovaries, closure of the Fallopian tubes, absence or ill- 
formation of the uterus, obliteration of the canal of the neck of 
the womb, sealing up of its mouth, or inflammation resulting in 
adhesion of the walls of the vagina, thus causing it to terminate 
before it connects with the uterus. It then forms a short, closed 
sac. At other times the vaginal passage cannot be entered in con- 
sequence of an imperforate hymen (virginal membrane). Again 
the cause of barrenness may be a diseased condition of the ovaries, 
preventing them from maturing healthy germs, or chronic in- 
flammation of the mucous membrane of the neck of the uterus 
which does not preclude the possibility of conception, but dimin- 
ishes its probability. It is one of the most common causes of 
unproductiveness, because the female seldom, if ever, recovers 
from it spontaneously. It has been known to exist for twenty 
or thirty years. 
Chronic inflammation of the vagina also gives rise to acrid 
secretions, which will destroy the vitality of the spermatozoa. 
Tumors connected with the ovaries, Fallopian tubes, uterus, neck 
of the womb, or even with the bladder or rectum may hinder 
impregnation. Finally, suppression of the menses or any dis- 
order of the uterine functions may disqualify the female for re- 
production. Flexions of the uterus, displacements, congestions 
and local debility may likewise prevent fertility. Sterility may 
result from impaired ovarian innervation, or undue excitement 
of the nerves, either of which will derange the process of ovula- 
tion. Even too frequent indulgence in marital pleasures some- 
times defeats conception. Prostitutes who indulge in excessive 
and promiscuous sexual intercourse seldom become pregnant. 
Anything that reduces the health and strength or enfeebles the 
functional powers of the system, is liable to disqualify the female 
for reproduction. 
1647. Treatment. Organic defects of the ovaries, absence 738 
COMMON SENSE MEDICAL ADVISEE. 
.of the Fallopian tubes and malformation of the uterus, are con- 
genital deformities which cannot be remedied. If there be 
closure of the mouth of the uterus, constrictions of the passage 
through the neck of the uterus or the mouth of the Fallopian 
tubes, a very delicate surgical operation may be successfully per- 
formed, which causes little if any pain or inconvenience to the 
patient and removes the impediment to fertility. When the 
vaginal walls are sufficiently united to prevent the copulative act, 
a simple surgical operation may be necessary to overcome their 
adhesion. When the virginal membrane obstructs the vaginal 
orifice, a similar operation may be necessary to divide it. 
1648. It is proper that I should suggest to the barren that if 
sexual intercourse be indulged in only very abstemiously, con- 
ception will be more likely to occur than if moderation be not 
exercised. I have also alluded to the fact 291) that there is 
greater aptitude to fecundation immediately before and soon 
after the menstrual periods than at other times. In fact many 
medical men believe that it is impossible for conception to occur 
after the fifteenth day following menstruation, up to within two 
or three days of the return of the monthly visitation. 
1649. Elongation of flic Aleck of tne Womb. 
An elongated condition of the neck of the womb, illustrated by 
Fig. 171, was first pointed out by Dr. Sims, 
as a cause of sterility. If this part be elon- 
gated, slim and pointed, as shown in the 
illustration, it is apt to curve or bend upon 
itself, thus constricting the passage through 
it and preventing the transit of seminal 
fluid into the womb. Dr. Thomas says, 
“ Even a slight degree of elongation, in 
which the cervix (neck) has a conical shape, 
has been observed to be frequently followed 
by that condition” (sterility). My own 
observations, embracing the examination of 
hundreds of sterile women annually, leads 
me to believe that this condition is among the common causes 
of barrenness. But fortunately it is one of the most easily over- 
come. 
Fig. 171. 
Conoid Neck (from Sims). 
1650. Treatment. This, if the neck he only slightly 739 
STERILITY. 
elongated, consists in splitting the projecting part, by the use 
of the hysterotome, but if it be a more aggravated case, nothing 
short of amputating a portion of the neck will suffice to over- 
come the mechanical impediment. This is perfectly safe and 
simple, and, strange as it may seem to those who are not familar 
with operations upon the womb, is but very slightly painful. 
I have never seen the least bad results follow it, but have 
known it to be the means of rendering numerous barren women 
fruitful. 
1651. Flexions and Versions of the Womb. 
Flexion of the uterus (womb), in which it is bent upon itself, as 
illustrated by Fig. 172, produces a bending of the canal of the 
neck, and constricts or obliterates it, thus preventing the passage 
Fig. 172. 
Fig. 173. 
Flexion, tj, Uterus, b, Bladder. 
Version, tj, Uterus, b, Bladder. 
of semen through it. Version of the uterus, in which the top 
or fundus of the womb falls either forward against the bladder 
(ante-version), as illustrated in Fig. 173, or backward (retro-ver- 
sion) against the rectum (lower bowel) may close the mouth of the 
uterus by firmly pressing it against one wall of the vaginal canal 
and thus prevent the passage of semen or spermatozoa into the 
womb. The treatment of these several displacements will be 
considered hereafter. I may here remark, however, that they 
are very amenable to proper remedies. 
1652. Diseased Ovaries, Fallopian Tubes, 
etc. Sterility may be due to diseases of the ovaries, Fallopian 
tubes or uterus. Chronic inflammation of the ovaries may result 
from uterine disorders, or peritonitis, and is commonly attended 740 
COMMON SENSE MEDICAL ADVISEE. 
with a sense of fullness, tenderness and pain in the ovarian region; 
these symptoms are more apparent upon slight pressure, or during 
menstruation. This malady is curable, although it may require 
considerable time to establish the health. It must be apparent 
when this chronic difficulty is the result of other disorders, that 
the indications are (1,) to restore health in the contiguous organs; 
and (2,) to relieve excess of congestion and nervous excitement 
in the ovaries. The patient should be very quiet during the 
menstrual period, and avoid severe exercise, or fatiguing occupa- 
tion, not only at that epoch, but during the menstrual intervals. 
All means and measures calculated to improve the general health 
are recommended. Not only freely use injections of warm water 
in the vagina every night and morning, but medicate them with 
borax, soda and glycerine. The surface of the body must be 
kept clean by the daily use of hand-baths, followed by brisk fric- 
tion. The bowels, if costive, should be regulated as suggested 
in a preceding part of this volume,when considering the subject of 
constipation; the system should be strengthened by the use of my 
Favorite Prescription, and if the blood be disordered, no better 
alterative can be found for domestic employment than my Golden 
Medical Discovery. If the patient do not in a few months im- 
prove under this treatment, the case should be placed under 
the care of some one well qualified by education and experience 
to critically examine and treat this affection. 
1653. Chronic Inltaiiiinatioii and Ulcera- 
tion. When enumerating the causes of barrenness, I men- 
tioned that chronic inflammation of the mucous membrane of 
the mouth and neck of the womb,was the most common disorder 
that defeats conception. Of all diseases of the female organs, 
this is, without doubt, the most common, and since it does not 
at first produce great inconvenience nor immediately endanger 
life, it does not excite the attention which its importance de- 
mands. It is overlooked, and when the attention is directed to 
the existence of this long-neglected disease, it appears so trivial 
and prevalent that it is not regarded as being the real cause of 
infertility in the patient. 
1654. When this disease has existed for a long time, the very 
structure of the parts involved becomes changed. The glands 
in the neck of the uterus secrete an unusual amount of glairy STERILITY. 
741 
mucus, resembling the white or albuminous part of an egg. The 
secretion is thick and ropy, and fills the entire mouth and neck 
of the uterus, thus preventing the access of sperm. In time, 
the mucous membrane becomes thickened, the inflammation ex- 
tends to the deeper structures, and on examination through the 
speculum we find the mouth of the uterus inflamed, hardened 
and enlarged, as represented by Fig. 22, in Coloi-ed Plate IV, or 
as in Fig. 23, of same plate. Fig. 25, Plate IV, shows the mu- 
cous follicles, just as they may be found all along the neck of 
the womb, in a state of inflammation and enlargement, and filled 
with a honey-like fluid, ready to burst, and giving rise to ulcera- 
tion and a thick discharge, as illustrated by Fig. 23, Colored 
Plate IV. It is then that we say the cervix or neck of the uterus 
is in a state of ulcerative degeneration. 
1655. If the reader inquire what predisposes to this chronic 
ulceration, I answer, feebleness of the constitution, impoverish- 
ment of the blood, scrofulous diathesis, want of exercise, uncleanli- 
ness, tight lacing, disappointment, excessive passional excitement, 
the use of pessaries for displacement of the uterus, or the inflam- 
mation may arise from overdoing, taking cold, etc. I can 
hardly enumerate one-half of the predisposing and exciting 
causes of this disorder. 
1656. The inflammation may be so mild, and the amount of 
the discharge so trifling in quantity, as scarcely to attract the 
attention. But after it obtains a firmer hold (and in most cases 
it is aggravated by exposure or incautiousness), the patient ex- 
periences dragging sensations about the pelvis, pain in the back 
and loins, accompanied with a bearing down sensation and 
numbness or pain extending to the thighs. 
The discharge is thick, starch-like, and generally irritating. 
The patient becomes irascible, capricious, fault-finding, sometimes 
moody and hysterical, easily discouraged, loses appetite, diges- 
tion becomes impaired, she grows thin and does not look or act 
as formerly. 
1657. Treatment. In offering a few hints for the do- 
mestic management of these abnormal conditions, I would at the 
same time remark, that while health may be regained by skillful 
treatment, yet recovery must be very gradual. I wish to guard the 
patient against entertaining too sanguine expectations of a speedy 742 
COMMON SENSE MEDICAL ADVISER. 
recovery. Although she may employ the best treatment known 
to medical science, yet from four to eight months may elapse 
before a perfect cure can be accomplished. In those instances 
of a scrofulous diathesis, where the recuperative forces are 
weakened, a radical cure is most difficult. It is equally true, 
however, that under domestic management alone, thousands 
have been restored to perfect health and became fruitful. 
1658. Hygienic management consists in toning the functions 
of the skin by daily bathing the surface of the body, and excit- 
ing the circulation by brisk friction. The patient should rise 
early in the morning, and exercise in the cool, fresh and invig- 
orating air. Those who sleep in warm rooms, or spend much of 
their time in bed, will continue to have congestion of the uterus, 
and habitual discharges from this enfeebled organ. The patient 
should daily take walks, and at regular intervals, increasing the 
length of the excursion from time to time, but not to the extent 
to produce fatigue. The bowels, if costive, must be regulated; 
(see article on Constipation). Strengthen the system by using 
my Favorite Prescription, to each bottle of which ask your drug- 
gist to add two drachms of citrate or pyrophosphate of iron. 
The vaginal mouth and neck of the uterus should be thoroughly 
cleansed by the use of the syringe, as suggested for the treat- 
ment of leucorrhoea. The use of some one of the lotions there 
advised will also be of benefit, if employed in the same thorough 
manner. 
1659. A most valuable course of local treatment, which may 
be adopted by any intelligent lady without requiring the aid of 
a physician, and one that will result in the greatest benefit when 
there is morbid sensibility, congestion, inflammation or ulceration 
about the mouth or neck of the womb, consists in applying to 
those parts a roll of medicated cotton or soft sponge, letting it 
remain there for twenty-four hours at a time. A piece of fine, 
soft, compressible sponge, as large as a hen’s egg, or a roll of 
cotton batting two-thirds as large, should have securely fastened 
to it a stout thread a few inches long, after which it is to be 
thoroughly saturated with pure glycerine. The vagina and affec- 
ted parts having previously been thoroughly cleansed with warm 
water and Castile soap, as advised in the treatment of leucorrhoea, 
this suppository should be passed up the vagina with the finger, STERILITY. 
743 
and pressed rather firmly against the mouth and neck of the 
womb, which from its enlargement and consequent falling below 
its natural position, will generally be found to be low down in 
the vagina, and so hardened as to be recognized 
and distinguished from the surrounding parts by the sense of 
touch. The glycerine having a very strong affinity for water, 
will absorb from the affected tissues large quantities of the 
serum effused into them, in consequence of their congestion and 
inflammation, and will thus deplete them and favor the reduction 
of the inflammation and enlargement. This explains the cause of 
the profuse, watery discharge which frequently follows the ap- 
plication. In about twenty-four hours after making the applica- 
tion it is to be removed by means of the attached thread, one 
end of which has been purposely left hanging out of the vagina. 
The vagina should now be thoroughly cleansed with warm water, 
one of the lotions suggested for the treatment of leucorrhoea 
used, and the glycerine application repeated. 
If there be no irritation nor tenderness of the vagina, great 
benefit will be derived from adding one drachm of tincture of 
iodine to each ounce of the glycerine employed, alternating the 
use of this every other day with the use of the simple glycerine. 
Or the iodine and glycerine may be used every third day and the 
simple glycerine on the two intervening days. As the iodine 
will color the finger somewhat, it is Avell to know that this un- 
pleasant effect may be almost or entirely avoided by coating that 
member with lard oil. Should, however, any stain occur, it may 
readily be removed by a solution of iodide of potassium. If the 
discharge be very fetid, three grains of carbolic acid should be 
added to each ounce of the glycerine used. The carbolic acid is 
very beneficial where there is ulceration about the mouth of the 
womb, as illustrated in Figs. 22 and 23, Colored Plate IY. 
1660. It will generally be well to alternate the Golden Medical 
Discovery with the Favorite Prescription, taking of each three 
times a day. By persevering in this coarse, nine-tenths of those 
who are thus afflicted will improve and be fully restored to 
health, fruitfulness and happiness. Should, however, the barren- 
ness continue, the case should be submitted unreservedly, either 
in person or by letter, to a physician skilled in the diagnosis 
and treatment of these chronic affections. 744 
COMMON SENSE MEDICAL ADVISER. 
MASTURBATION A FRUITFUL CAUSE OF DISEASE 
IN WOMEN. 
1661. It seems to be a general law of physiology, that any 
faculty becomes stronger by being exercised. This is also true 
of the venereal propensity. Indulgence makes it a powerful and 
controlling passion. Responsibility begins with life, and there 
is not an organ in the body but that implies function. How per- 
fectly easy it is to pervert the sensibilities and functions, and 
render them morbidly active and domineering; and the responsi- 
bility of such perversion does not altogether rest with the 
growing child or promising maiden, but it belongs also to parents 
and teachers, who should guide, warn and instruct concerning the 
danger of arousing the propensities. I have known many young 
women of lovely disposition, exemplary in their lives, whose 
health was undermined and career ended before attaining their 
twenty-third year, in consequence of self-indulgence begun before 
they were eight years old. 
1662. Nymphomania. The diseased conditions result- 
ing from masturbation have generally, when occurring in the 
female, been designated by the term “ Nymphomania,” a word 
which has been defined as signifying “ a disease in females, atten- 
ded with uncontrollable and insatiable desire for sexual inter- 
course.” But since this “ insatiable desire ” is only one of many 
morbid manifestations liable to result from self-gratification of 
the sexual passions, or from excessive venery, and in fact is fre- 
quently absent, the term is an illy chosen one to designate the 
numerous and divers disorders of the system consequent upon 
such abuses and excesses. Instead of an inordinate desire for 
venery, there is in many cases a disposition of coldness and indif- 
ference toward the opposite sex — a lack of sexual passion. 
1663. Spermatorrhoea in Women. Some authors 
have employed the term “ Spermatorrhoea ” to designate those 
symptoms and lesions of function, consequent upon masturbation 
in the female, since they are the counterpart of those produced 
in the male by the same cause, and which have been designated 
by that term. But it is a misnomer as applied to women, since 
they cannot lose sperm. 
1664. As the semen or sperm of the male is a most vital MASTURBATION. 
745 
secretion, and its excessive loss attended with debilitating results, 
so the discharge occurring on the part of the female during a 
sexual orgasm, is followed by depression. It has long been my 
opinion, however, that the general and nervous debility resulting 
from masturbation in both male and female, is caused more by 
the unnatural shock produced upon the system of nerves, which 
are largely distributed to the sexual organs, than by the at- 
tendant loss of vital secretions. For the moderate, and 
natural gratification of the sexual propensity is conceded by 
all physiologists to be healthful rather than otherwise, but the 
unnatural gratification sought for in the practice of onanism 
(masturbation), although perhaps attended with no greater sem- 
inal loss at the time, is always productive of injury to the system. 
Strike the region of the stomach, or inflict a blow upon the 
testicles, and you produce such a powerful shock upon the system 
through the sympathetic nerves, which are so freely distributed 
to those parts, as to instantly annihilate strength, and render the 
man as weak as a child. So the unnatural impression produced 
upon the sexual organs by masturbation, although it does not so 
powerfully and suddenly deprive the system of its strength, yet 
it accomplishes the same result gradually, and makes it the more 
permanent as a chronic weakness. 
1665. Discarding both nymphomania and spermatorrhoea as 
inappropriate terms to designate the disorders caused in the 
female by self-pollution, and without any attempt to substitute 
for them better names, I shall proceed to draw a pen picture of 
a train of symptoms which, although sometimes resulting from 
excessive sexual intercourse, is more commonly the result of soli- 
tary indulgence. Inordinate sexual desire,which is so frequently 
a result of this vice, may also be caused by uncleanliness, pruri- 
tus vulvce (1 1634), by reading obscene books, or by allowing 
the mind to dwell upon lascivious subjects. 
1666. It is superfluous to say that drunkenness is a disease. 
I have not a doubt but that after the habit has become fully con- 
firmed, the propensity to indulge in intoxicating liquors becomes 
ungovernable, stronger than both reason and will. It completely 
subjugates the person, and he must yield to the morbid demands 
of this degrading appetite. Just so in regard to this disease, for 
whenever any propensity becomes inordinate, it is a morbid 746 
COMMON SENSE MEDICAL ADVISER. 
affection. The allurements of the flesh are ever presented to us 
under a deceptive guise, and so they come to the young and 
unwary with bewitching sweetness, until consumption not unfre- 
quently ends the siren enchantment! Will those whom we most 
tenderly love, heed this timely warning? 
1667. True, the peculiar endowments of the sexual organiza- 
tion are calculated to impart pleasure; but solitary gratification 
never awakens joy and gladness, social delight and love; it only 
sinks the individual in selfish, sensual experience. It tends to 
make her gloomy and unhappy, and estranges her from humanity. 
Such an one dares not whisper her secret trouble to a sister or 
mother; no, hardly has she the courage to breathe it to the physi- 
cian who undertakes her rescue. But, at last, feeling conscious of 
being within the charmed circle of some dangerous whirlpool of 
disease—the constitution giving away—and in dread of impend- 
ing danger, she submits the history of her case, and this habit 
is found among the causes of her troubles. 
1668. In a letter addressed to me, and bearing date Septem- 
ber 7th, 1870, the writer, a lady twenty-four years of age, says 
that she commenced the habit of self-indulgence when but fifteen 
years old, without suspecting that she was doing wrong, and had 
continued it nearly to the time when she wrote me the letter. 
Her health began to fail, and she did not suspect the cause of 
her decline, until by chance she learned that this habit was very 
prostrating, and then she firmly resolved to abandon the practice. 
But it had become so fixed, and the passion was so strong and 
overpowering, that she was unable to restrain herself, even after 
realizing the terrible mischief that it was producing. Catarrh had 
attacked her in its worst form, the eyes were bloodshot, swollen 
and watery, the sight obscured, she grew deaf and had to con- 
verse by signs. Her strength failed, her memory was gone, and 
she had partially lost her faculties of thought. Finally, her voice 
failed, leucorrhoea added to her troubles, she became emaciated 
and utterly discouraged. She was well educated, possessed excel- 
lent physical endowments, and before becoming prostrated by 
this habit, her future was clear and promising. But now all 
her bright hopes were shaded with sorrow, the fine physique 
had become a miserable wreck, and she made touching appeals 
to my skill for medical relief. I have given a true delineation MASTURBATION. 
747 
of her symptoms, and yet many almost incredulously will ask, 
is this an actual case ? I answer, certainly it is a correct report 
of the case of a patient whom I have treated. I could, if 
permitted, illustrate the prevalence of this habit and its dire con- 
sequences by hundreds of letters, but I do not propose to draw 
upon my professional records, to substantiate my statements. 
1669. Since penning the above sentence, I have thought, pos- 
sibly, that it might be proper to make one exception to the above 
rule, select a letter, and publish it for the benefit of those ad- 
dicted to this habit. If a warning voice, impassioned with 
sorrow, coming from the gloomy depths of affliction, cannot 
arrest the attention, then certainly my own words will be of no 
avail. Let this letter be read and pondered by those who can 
be rescued before this disease casts the mind into melancholic 
desperation, before it hopelessly disorders the love of life with 
suicidal mania, before relentless propensity overthrows modesty 
and all chaste restraint; aye, before the last stage of this fearful 
disorder shall be reached, when disgusting obscenity and mental 
alienation complete the downfall. The heart of every one who 
reads this letter will be filled with the kindliest emotions and 
sympathy for one who is tearfully and prayerfully wrestling, 
with all her might, to overcome this pitiless and implacable pro- 
pensity. She artlessly portrays the terrible moral struggle, and 
many will add their prayers to hers for her safe deliverance. 
This letter I now transcribe exactly, without the alteration of a 
single word, only oihitting one sentence and the name and resi- 
dence. It commences as follows: 
“ Please peruse carefully, and hold the signature of this letter sacred. 
November 19th, 1874. 
It. V. Pierce, M. D. 
Sir:—As you said my case was one which required 
great discrimination in adapting remedies to the requirements of my own 
constitutional peculiarities, and thinking you perhaps had reference to 
‘ Nymphomania,’ I would like to make some remarks as to how the 
disease affects me. I certainly never learned masturbation. I said I 
indulged in it,when a mere child. Just as far back as I have a recollec- 
tion of anything, I was addicted to that habit; I know I was not more 
than four years of age. I, of course, had no regard whatever for the 
o.ther sex. It has become a second nature; I sometimes feel discouraged; 748 
COMMON SENSE MEDICAL ADVISER. 
fear my case is incurable; I know I must have been diseased from my 
infancy. 
As I said in my last letter that within the last eight years, I had more 
control of the passion and didn’t indulge so frequently, the control over 
which, I owed to a ‘ Higher Power.’ At the age of twenty-three, I 
resolved to live a Christian, and knowing that vile habit to be morally 
wrong, I determined that with Divine assistance I would abandon it, 
and did, in a measure. Have avoided evex-ything that would tend to 
excite those desires, as I would the poisonous viper. I think I have gone 
as long as a year without indulging in self-abuse. * * * * * * 
***** * I know I read your books with the purest intention, 
though I cannot read about the disease, or look on those pictures of the 
generative or urinary organs, but my sexual organs are excited and 
stimulated to the very utmost, and masturbation is ii’resistible. I have 
actually left my bed at lxight in order to masturbate, so intense was the 
desire that I couldn’t rest, until I gratified it. I never had the orgasm 
to occur spontaneously, only during the night, and then, vexy seldom. 
It always requires some effort on my part to pi'oduce that exquisitely 
thrilling sensation, of which you speak. When the orgasm occurs 
during sleep, I feel as much exhausted as I do when awake. Sometimes 
when these orgasms occur, I experience pains, like those I have during 
menstruation. One single lascivious thought stimulates those organs. 
Meeting with gentlemen for whom I have any affinity, excites me. 
Sometimes there is a painful sensation about those organs, when my 
sexual desires are excited. 
I have noticed that when I masturbate, or the organs are excited, 
there seems to be a flow of watery fluid so as to dampen the linen. 
Though I am very cleanly in person, there is at all times a discharge 
from those parts of a white mucus resembling cream, sometimes of a 
ropy character. I thought I would mention that, as I did not know 
whether it was natural or a continual flow of secretion. 
I have always been reserved, timid, distant, suspicious, no self-confi- 
dence, which has caused me much unhappiness. I’ve shed tears, oh, 
bitter teal's, when I have thought what perfect dominion this vice has 
over me; and whenever I commit the act, I deeply regret it, and think it 
shall be the last. But I sometimes think, to stop the sun in his course 
would prove as easy a task, as to abandon that habit entirely! I have in- 
tense sexual desire, and not being able to gratify it in a natural way, and 
refraining from masturbation, I suffer,—you only know, how much I 
suffer. Pardon me for addressing such language as this to you; I never 
thought I would express myself in such a manner to one of my own sex, 
much less to a gentleman! And indeed, I liavn’t a lady friend (not my 
most intimate,) to whom I would disclose such facts, as I have to you. 
To you — and why to you ? You have encouraged me to hope for relief! 
You say, all who confide their cases to you, ‘ have the assurance that 
they will be dealt with upon rigid principles of honor.’ I believe it; MASTURBATION. 
749 
therefore, this is why I say, lto you.' Should your medicines fail to do 
what I expect, I should be most sadly disappointed. You say special 
advice, rules and directions will be furnished at the time of sending 
medicine. If your advice and rules are in reference to this disease, 
please send them separate from the directions for using medicines, as I 
don’t wish any one to see them. 
Very Respectfully, 
1670. This letter is only a type of those which I receive 
upon this subject year by year, though few are so minutely 
accurate and truthful in the account of the early inception of the 
habit, or describe so faithfully the power that it has acquired over 
them, or disclose the brave determination and Christian heroism, 
evoked to overcome it. Few indeed are able to so feelingly por- 
tray the fearful struggle going on, which, by Divine help, shall 
result in her mastery over the animal nature. I do not publish 
this letter to gratify any prurient curiosity. It has seemed to me 
that by withholding the signature of this gifted and unfortunate 
lady, environing her personality with impenetrable surroundings 
of secrecy, that her frank confession of suffering, terrible experi- 
ences and deep contrition, must convince the unsuspecting, of 
danger, and warn the inexperienced against the evils of this habit. 
1671. See, then, where this morbid passion leads, and how 
despotic is its sway! When it gets control of a person, it is as 
though an unclean spirit had entered, subduing the will, weaken- 
ing the moral forces, enfeebling the intellectual faculties, in- 
creasing the power of the temptation and overcoming every 
influence opposed to its gratification. It swallows up every other 
interest, even when the intellect is clear, and the sense of wrong 
keen, for the individual has become a slave to this morbid 
impulse. 
1672. By a titillation of the clitoris, the sexual orgasm is 
produced, leaving an indellible impress upon the nervous system. 
Orgasms occur spontaneously at night, during lascivious dreams, 
or when in the company of those of the opposite sex, and the 
results are as disastrous as in the male. The patient manifests a 
retiring and diffident manner and love of solitude. She becomes 
despondent and gloomy; her natural vivacity and glee depart; 
her complexion loses its delicate blush, the eye its lustre, the COMMON SENSE MEDICAL ADVISER. 
voice its melody; her breasts lose their rotundity, become flabby, 
or are not developed, and by its debilitating influence she is 
rendered extremely susceptible to every disease. The menses 
are disturbed, and leucorrhcea, falling of the womb, hysteria, 
sterility, chronic uterine or ovarian congestion, epilepsy and 
other nervous symptoms, are common results. 
1673. Some young women suffering from the results of mas- 
turbation experience an indescribable feeling of illness through- 
out the whole body, which expresses itself in a general trembling 
of the limbs, chilliness, painful drawing or dragging sensations 
in the abdomen, and relaxation of all the muscles, accompanied 
subsequently with various illusions of the imagination, fearful 
dreams, hysteria, and sometimes with convulsions. At the same 
time, the skin is sallow and dry, the complexion pale, the breath 
fetid, the breasts shrunken and flaccid, the abdomen painful, the 
pulse small, weak, contracted, and the head and uterus are often 
the seat of violent pains. In some cases, the disease assumes a 
more violent mental form, with great lascivious excitement, in 
W'hich the most highly educated and refined women even, fre- 
quently talk in the most indecent manner, and place themselves 
in the most improper situations and attitudes. 
Young ladies of highly excitable temperaments so intensify 
their sexual ardor by self-indulgence, that they are apt to betray 
their lascivious longings to their male companions, and thus 
many times give way to temptation and are initiated into lives 
of prostitution. Some are actually convulsed by their emotions, 
which are ungovernable. 
Sterility is quite frequently a sequence, and the wife is disap- 
pointed to know of her incapacity for bearing children, and 
regrets her error in youth. It blunts the sensibility of the parts, 
so that she cannot enjoy sexual intercourse, and the husband 
calls her cold and passionless. Many times coition is exceedingly 
painful to her, and she avoids it in every way possible. In the 
absence of pleasure with her husband, she continues the secret 
vice, only to reap sorrow. lie, disappointed in his legitimate 
embraces, many times seeks other means of gratification, and 
then trouble begins. 
1674. Treatment. The habit must absolutely be relin- 
quished. If necessary, the arms should be tied or restrained, 751 
MASTURBATION. 
and every precaution taken to prevent indulgence, especially 
during the night time. Let the patient practice early rising, 
and walk or engage in some kind of labor. Let the animal 
forces be expended in mental or physical employments. Dimin- 
ish the sensibility and irritability of the sexual organs by using 
cold baths. Avoid eating highly seasoned food, and live ab- 
stemiously. The bowels must be kept regular, free from 
congestion and irritation, which are attendant upon constipation. 
(See Constipation.) Avoid all reading calculated to excite the 
passions, and associate only with those who are rigidly chaste in 
their ideas and eonversation. It is very important to establish 
the habit of daily exercise in the open air, in order that at night 
the fatigue of the body shall absorb and divert the sexual feel- 
ings. It is equally necessary to use daily and regularly one or 
two baths, one upon rising in the morning, and if the patient 
have sufficient vitality, another in the middle of the afternoon, 
each bath to be followed by brisk friction applied to the surface. 
1675. Whenever it is known that this disease exists, it is im- 
portant that the case be submitted to the remedial ti'eatment of 
an experienced physician. To give to the non-professional 
reader a full list of the remedies which are found useful in differ- 
ent temperaments and constitutions, with full directions, would 
till the pages of a small volume, and serve to confuse and per- 
plex, rather than enlighten and benefit. It would lead only to 
experimental trials, failures and loss of faith in medicine,whereas, 
if these remedial agents are skillfully directed, the result is gen- 
erally salutary and satisfactory. In this connection, I may be 
allowed the remark, that the depreciation of the profession and 
the undervaluation of drugs, so far as my observation extends, 
not only in this, but in all other diseases, originate with those 
who are inexperienced, uneducated and of course unqualified for 
the practice of medicine. There is no such thing as infallibility 
in any art, the perfection of which depends upon the exercise of 
the finite faculties of man; but occasional failures in any profes- 
sion furnish no good grounds for such sweeping detractions as 
nowadays fill the pages of journals published by real pseudo- 
hygienic reformers ! 
1676. One thing should he borne in mind, that patients af- 
flicted with this disease must rigidly observe the sanitary 752 
COMMON SENSE MEDICAL ADVISER. 
regulations which I have advised, and persevere in the use of 
remedies adapted to their case. They will require all the help 
that may be obtained from both of these sources, to overcome 
this malady and regain that complete self-control which is the 
indispensable accompaniment of health. 
1677. The term Abortion is applied to denote the premature 
expulsion of the foetus. If the expulsion take place within four 
months after impregnation, it is termed abortion/ if between the 
fourth and seventh month, miscarriage/ if after the seventh 
month, but before the completion of the full period of gestation, 
premature labor. 
ABORTION. (Miscarriage.) 
1678. Abortion may be due to (1,) those agents which act 
directly upon the uterus and cause the expulsion of the foetus; 
(2,) those which occasion the death of the foetus, thereby effect- 
ing its ejection; and (3,) it may be criminal, that is, designedly 
produced by direct agencies intended for that purpose. 
1679. HyilipioillS. The premonitory symptoms are pain 
in the loins and lower part of the back, a dull pain in the abdo- 
men and thighs, sickness at the stomach, coldness, chilliness and 
palpitation of the heart. The membranes and blood-vessels of 
the uterus become lacerated and cause profuse hemorrhage. The 
discharge of blood from the vagina is sometimes attended with 
excessive pain, frequently more severe than that of labor. 
1680. The Causes which directly act upon the uterus to 
produce abortion, may be violent exercise, lifting, accidents, or 
injuries from blows, falls, etc. Nervous susceptibility, plethoric 
condition of the system, anemia, exhaustive discharges, use of 
improper food, uterine displacements, congestion caused by 
excessive sexual excitement, general debility or muscular irrita- 
bility, which is sometimes so great as to produce contractility of 
the uterus before the term of pregnancy is completed; inflam- 
mation of the cervix, ulcerations of the uterus, or any previously 
existing disease, may produce abortion. When it has once taken 
place, it is apt to recur at about the same time in subsequent 
pregnancies. 
1(581. The causes which occasion the death of the foetus 
are, a diseased condition of the embryo, as disease of the head, 753 
ABORTION. 
chest, amnion or placenta, also convulsions or peritoneal inflam- 
mation. The embryo is so extremely delicate in organization 
that even a trivial change in the solids or fluids of which it is 
composed, might destroy it. Again, the union of the placenta 
with the surface of the uterus is so slight that a moderate blow 
might be sufficient to sever the connection, and the blood would 
be effused between the uterus and placenta, an occurrence likely 
to prove fatal to the foetus. 
1682. Criminal AS>orti©n is often secretly practiced 
by parties who desire to rid themselves of the evidence of shame 
and immorality; or else by those in wedlock, who would by so 
doing avoid the care and responsibility of rearing offspring. 
Statistics show that this criminal practice is fearfully prevalent, 
undermining the health of women and corrupting the morals 
of society. I cannot pass this subject in silence. Those who 
frustrate the processes of nature by violating the laws of life, 
incur fearful penalties. All the functions of mind and body are 
deeply sympathetic, and vitally concerned in reproduction. The 
Divine law, “Thou shalt not kill,” is instinctively iterated by 
nature. Its obligation cannot be evaded, and its penal effects 
are pain and misery. All such transgressors carry with them 
the consciousness of guilt and the feeling of secret wToe. 
“ O God! that horrid, horrid dream 
Besets me now awake! 
Again, again, with dizzy brain, 
The human life I take, 
And my red right hand grows raging hot, 
Like Cranmer’s at the stake.”—Hood. 
1683. And what shall we say concerning abortionists,— men 
and women who are willing to engage in the murder of innocents 
for pay? True, there may be circumstances in which it is not 
right to continue in the pregnant condition, for example, when 
the children from an unfortunate marriage are idiots, or the 
female pelvis is deformed so that the mother cannot bear a 
living child. All such cases should be submitted to the family 
physician, who should well understand all the circumstances and 
facts relating to the case. Let him summon other physicians in 
counsel, and their deliberations may determine the rightfulness 
or necessity of abortion. 754 
COMMON SENSE MEDICAL ADVISER. 
1684. Parties residing at a distance have written to me, 
others have made personal application, even under circumstances 
when it might perhaps have been right to induce abortion, if they 
had made an appeal to their family physician and followed his 
advice. I wish to have it distinctly known that I shall not 
assume the duties belonging to other physicians, and that under 
no circumstances will I prescribe medicines or resort to any 
operation, whereby parties may become relieved of pregnancy. 
I utterly detest the practice and regard it as flagrantly criminal. 
1685. Mechanical means are resorted to by abortionists, and 
many ladies bring about miscarriage upon themselves. It always 
terminates in lasting injury if they survive it. Some medicines 
will produce abortion, though they are uncertain and unsafe. 
Advertised nostrums, as “ Female Pills,” and “ Periodical Drops,” 
are villainous frauds, yet unmarried females who have become 
pregnant, young wives who do not wish childi’en, older ones who 
have raised children, conceive readily and do not wish any more, 
desiring to abort without the knowledge of friends,will waste their 
means upon these things only to meet with utter disappointment. 
A quack in New York testified that his advertised pills, “double 
strength, that never fail, and sold for $5 per box,” were made of 
soap and bread. Such is charlatanism ! Occasionally these male 
and female ghouls receive their just punishment. An opinion 
is quite general that if abortion is produced before the move- 
ments of the foetus are felt, there is no harm in it, but it must 
be known that life begins with conception, and in all abortions, 
at whatever period of pregnancy, life is destroyed. Whoever 
disobeys the Divine injunction to which I have referred, can- 
not escape his own consciousness of having committed wrong, 
and the compunction, anguish, and bitter, pitiless remorse which 
ever after will disturb the soul. 
1686. Treatment. In threatened abortion there is pain 
in the back or “ low before,” and later some how of blood. The 
first object is to obtain perfect rest and quiet, and take the recum- 
bent position. By lying down, the blood will be more easily 
diverted to the surface of the body. Let the room be cool and 
all company avoided. A Dover’s powder may be administered, 
which will assist in determining the blood to the surface and ex- 
tremities of the body. Let the patient lie on a hard bed rather DISPLACEMENTS OE THE WOMB. 
755 
than upon a soft one, and the mind must be quieted. All 
excitement favors abortion. If there be no Dover’s powder 
convenient, the patient may use a tea of Canada fleabane, or take 
five drops of the oil. If the flow of blood equal a gill in amount, 
there is little hope of preventing abortion, and the conduct of 
the case should be confided to the family physician. 
DISPLACEMENTS OF THE WOMB. (Female Weakness.) 
1687. The relative position of the womb and the surrounding 
organs, when in a state of health, is well illustrated by Fig. 106, 
Page 217. The womb is supported in place by resting upon the 
vaginal walls, and by a broad ligament on either side, as well as 
by other connective tissues. By general debility of the system, 
the supports of the womb, in common with other tissues of the 
body, become weakened and inadequate to perfectly perform 
their duty, thus permitting various forms of displacement of 
the uterus to occur. 
1688. Prolapses or Falling of the Uterus, or, 
as it is often called, “Female Weakness,” is a common form of 
displacement. It has been erroneously regarded as a local uterine 
disease, requiring only local treatment, instead of considering it 
as only a symptom of general derangement and organic feeble- 
ness—a lowering of the tone and usefulness of every organ, and 
therefore requiring constitutional restoration and tonic treatment. 
Hence variously devised supporters and pessaries have been in- 
vented to retain the womb in position after replacing it. It is a 
law of physiology, that an organ is strengthened by use, and 
that want of exercise weakens it. The blacksmith’s arm is de- 
veloped and strengthened by daily exercise. Support his arm in 
a sling, and let him cease to exercise it, and the muscles are grad- 
ually wasted and weakened in consequence. So, when artificial 
supports, as rubber, glass, metalic or other pessaries and contri- 
vances, are used to retain the womb in position, thereby relieving 
the supporting ligaments and tissues of their normal function, 
these natural supports of the uterus are thereby still further 
weakened, and the prolapsus only made worse when the artificial 
support is discontinued. Besides, all these mechanical contri- 
vances are irritating to the womb and vagina, wdiich are so 
delicately organized and supplied with sensitive nerves, and COMMON SENSE MEDICAL ADVISEE. 
frequently produce congestion, inflammation, and even ulceration, 
by their contact with such delicate structures, thus rendering the 
patient’s condition much worse than before their employment. 
These worse than useless appliances, should, therefore, never be 
resorted to for the temporary relief which they sometimes afford. 
Common sense suggests to the skillful physician, dependence 
upon constitutional treatment for the cure of this morbid condi- 
tion. 
1689. Symptoms. The prominent symptoms of simple 
prolapsus of the uterus, when the displacement is sufficient to 
cause any serious disturbance, are a sensation of dragging and 
weight in the region of the womb, pain in the back and loins, 
inability to lift weights, great fatigue from walking, leucorrhoea, 
frequent desire to urinate and irritation of the lower bowel; dis- 
turbance of the functions of the stomach, is common. The womb 
may come down so that its mouth will protrude from the vaginal 
orifice, and in very rare cases it wholly protrudes, and may be 
inverted. 
1690. Causes. As I have already intimated, general de- 
bility favors prolapsus of the womb, but various other general 
and local circumstances and conditions also favor its occurrence. 
Wearing heavy garments supported only by the hips, compress- 
ing the waist and abdomen by lacing, or tight clothing, thus 
forcing the abdominal organs down upon the womb, are all 
fruitful causes of this affection. Excesses in sexual intercourse 
give rise to leucorrhoea, and a relaxed condition of the vagina 
upon which the womb rests, and in this way one of its supports 
is weakened. Enlargements of the uterus from congestion, and 
inflammation or tumors, also favor the occurrence of prolapsus. 
Abortion may leave the womb enlarged, its supports weakened 
and result in this displacement. 
1691. Flexions and Versions. Instead of sliding 
down into the vagina, as in prolapsus, the uterus is liable to fall, 
or be forced into various other malpositions When the uterus 
is bent upon itself, it is called flexion. If the bending be back- 
ward, it is called retroflexion; if forward, anteflexion. Fig. 174 
represents the former condition, the uterus being flexed backward 
so that the fundus, or upper part of the womb, is pressed against 
the rectum, while the neck of the uterus remains in its natural DISPLACEMENT OF THE WOMB. 
757 
position. This is a common form of displacement, and generally 
occurs between the ages of four- 
teen and fifty. 
1692. Symptoms. The 
prominent symptoms of retroflex- 
ion of the uterus are, a sense of 
weight in the region of the rectum, 
difficulty in evacuating the bowels, 
and sometimes a retention of the 
fa3ces. There may also be supres- 
sion of the urine, and the menses 
may be diminished in quantity. If 
retroflexion be due to chronic en- 
largement of the uterus, caused by abortion or parturition — the 
patient then suffers from an immoderate flow of the menses. 
Fig. 174. 
Retroflexion, u, Uterus (Womb). 
b, Bladder. 
1693. Causes. The principal causes of retroflexion are 
congestion, enlargement and tumors of the uterus. Congestion is 
very liable to occur in women possessing an extremely active 
temperament as well as in those of sedentary and indolent habits. 
Experience furnishes the following general conclusions: (1,) That 
retroflexion is a common displacement in both married and un- 
married women; (2,) that it is a secondary affection; (3,) when 
it is caused by congestion, the menses are painful and reduced 
in quantity; and (4,) that there is pain in the back and a sense 
of weight in the region of the rectum. In some instances there 
is a reflex irritation of the mammary glands, and a consequent 
secretion of milk. There may also be nausea and vomiting, 
which symptoms lead to the erroneous opinion that the patient 
is pregnant. 
1694. Anteflexion of the uterus denotes a bending forward 
of the body and fundus of the uterus, while the neck remains in 
its natural position. 
1695. In versions of the uterus, neither the body nor neck of 
the womb is bent upon itself, but the whole organ is completely 
turned or changed in its direction. 
1696. Retroversion of the uterus, illustrated by Fig. 175, sig- 
nifies a change in the position of the womb, so that the upper, or 
fundal portion of the organ, drops back towards the concavity 
of the sacrum (spine), while the neck preserves a straight line in 758 
COMMON SENSE MEDICAL ADVISER. 
the opposite direction. The fundus presses forcibly against the 
rectum, while the upper part of 
the vagina abruptly bends and 
forms an acute angle near the 
mouth of the uterus. 
1697. Symptoms. Retro- 
version is indicated by bearing 
, down pains in the loins, and difti- 
culty in having a movement of the 
bowels. The faeces may accumu- 
late in the rectum, because they 
cannot pass this obstruction. 
1698. Causes. Jumping, 
falling or undue pressure from the abdominal contents, may 
suddenly retrovert the uterus, and sometimes it results from 
obstinate constipation. 
Fig. 175. 
Retroversion, b, Bladder, 
u, Uterus (Womb). 
1699. Anteversion. This term designates another malposition 
of the uterus, in which the fundus,or top of the uterus falls forward 
as illustrated by Fig. 176, while 
the neck points in the opposite 
direction towards the hollow of 
the sacrum. This position of the 
womb is the reverse of that in 
retroversion. In its natural position 
the fundus of the uterus is slightly 
inclined forward, and any pressure, 
oy forward traction, will cause it to 
fall still further in that direction. 
1700. Symptoms. One of 
the most common symptoms of an- 
teversion is the desire to urinate often, in consequence of the 
weight and pressure of the uterus upon the bladder. It some- 
times offers a mechanical obstacle, obstructing the free flow of 
the menses. 
Fig. 176. 
Anteversion. u, Uterus. B, Bladder. 
1701. Causes. The causes may be tight lacing, prolapse 
of the abdominal organs, weakness of the supporting ligaments, 
or it may result from enervating habits. 
1702. Treatment. In treating all the various displace- 
ments heretofore considered, the prominent indication is to tone 759 
DISPLACEMENT OF THE WOMB. 
up the general system, for by so doing we also strengthen the 
uterine supports. 
Digestion must be improved, the blood enriched and nutrition 
increased, so that the muscles and ligaments which retain the 
womb in position will become firm and strong. The womb will thus 
be gradually drawn into position by their normal action, and firmly 
supported. It is a great mistake, made by physicians as well as 
patients, to consider “ female weakness ” as a local disease, re- 
quiring local treatment. A restoration of the general health will 
result in the cure of these displacements, the uterus will regain 
its tone and muscular power, and all local derangement, with its 
attendant pain and morbid symptoms, will disappear. 
1703. It is true that female weakness maybe associated with 
inflammation and ulcers,which will require appropriate treatment, 
as elsewhere suggested, but simple displacement of the uterus may 
be remedied by giving strict attention to the following advice. 
Sleep on a hard bed — never on feathers, rise early, take a 
hand-bath, then follow with a short walk before breakfast. 
Dress the body warmly, but allow the lungs easy and full 
expansion. Eat moderately — thi-ee meals per day — of those 
articles which are nutritious and readily digested. Keep the 
bowels regular by the use of proper food. If they be con- 
stipated, employ the treatment suggested elsewhere in this 
volume for that condition. Avoid retaining the standing pos- 
ition too long at a time, especially when the symptoms are 
aggravated by it. Many ambitious women make it a point to 
disregard their increasing pains, and keep upon their feet as long 
as possible. Such a course is extremely injurious and should be 
avoided. 
1704. As a general restorative and uterine tonic, nothing sur- 
passes my Favorite Prescription, which is sold by druggists and 
accompanied with full directions for use. If the back be weak, 
add one drachm of quinine, one ounce of the fluid extract of 
black cohosh-root, and half an ounce of the tincture of capsicum, 
to half a pint of alcohol, and rub the spine with it every night 
on going to bed. If leucorrhcea be an attendant symptom, the 
treatment suggested for it in 1639 should be employed. 
1705. By persevering in the rational and methodic treatment 
which I have suggested for the various displacements of the 760 
COMMON SENSE MEDICAL ADVISEE. 
womb, nearly all, suffering from such ailments, may be fully 
restored to health. The patient must not expect speedy relief. 
Considerable time will be necessary to bring the general system 
up to a perfect standard of health, and until this is approached, 
no great improvement in the distressing symptoms must be 
expected. In rare cases from adhesions contracted between the 
womb and surrounding tissues, binding the uterus in its mal- 
position, or from great enlargement or pressure of surrounding 
organs upon it, the treatment suggested may not prove effectual 
in restoring the organ to its normal position, and a physician’s 
services will be required to correct the displacement. After 
being restored to its proper position, which, if adhesions do not 
bind it down, is easily effected by the employment of an instru- 
ment called a repository then the treatment suggested should be 
renewed. If it be replaced by this mechanical operation before 
the system and its supports have been properly strengthened by 
a course of tonic treatment, it will fall back into the malposition 
previously occupied by it. Hence replacement by operation 
should not first be resorted to in these cases; generally it will 
not be required at all, and when it is, it should be followed by a 
protracted tonic and restorative course of treatment. 
ULCERATION OF THE UTERUS. 
1706. Ulceration is the process by which sores or ulcers are 
produced. It is characterized by the secretion of pus, or some 
kind of discharge, and is continued as a local disease, by the 
operation of constitutional causes. Ulcers are generally symp- 
tomatic of other morbid conditions, and have a tendency to 
enlarge. 
Ulcers may form in the mouth or neck of the uterus, and, 
omitting cancerous ulcers and those of a syphilitic character, 
which are considered elsewhere, may be classified as (1,) Granular 
and (2,) Follicular. 
1707. Granular Ulcer. This variety of ulcerative de- 
generation is the most frequent, and may exist for some time 
without exciting any suspicion in the mind of the patient that 
she is afflicted with any such morbid process. A certain amount 
of local inflammation exists, and the mouth of the uterus is 
uneven, rough and granular. If a local examination be made ULCERATION OE THE UTERUS. 
761 
with the speculum, it distinctly discloses the condition of the 
mouth of the uterus, which often appears as represented in Col- 
ored Plate IV, Fig. 22. 
Fig. 177. 
The Speculum. 
1708. There are a variety of specula, but the kind repre- 
sented by Fig. 177 consists of a tube of glass coated with quick- 
silver and covered by India rubber, -which is thoroughly varnished. 
By using this instrument, the condition of the parts and the ulcers 
can be as distinctly seen as when located upon the external sur- 
face of any part of the body. 
1709. Follicular Fleer. When the mucous follicles 
of the neck of the uterus are inflamed they enlarge and become 
filled with a fluid like honey, presenting the appearance illus- 
trated by Fig. 25, Colored Plate IV. This secretion, in conse- 
quence of inflammation, is not discharged. The result is that 
these follicles continue to enlarge until they burst, and we may 
then see in their place a red, elevated, angry looking eminence 
which is called a follicular ulcer. 
1710. Symptoms. The severity of the symptoms de- 
pends upon whether the ulceration be simple or associated with 
purulent leucorrhoea and hemorrhage. If ulceration be slight 
and local, few symptoms will be present; but if it be associated 
with uterine debility, congestion and inflammation of the mucous 
membrane of the uterus, the discharge may be profuse, and 
cause fixed pain in the back and loins, a bearing down sensation 
and great difficulty in walking. The discharge is weakening, as 
it impoverishes the blood and thus reduces the strength. 
1711. Causes. Ulceration maybe induced by anything 
that excites inflammation of the lining membrane of the mouth 
and neck of the uterus. The use of pessaries, abuse of sexual 
intercourse, injuries occasioned by giving birth to children, con- 
gestions, enlargements and displacements, may all operate as 
causes. 762 
COMMON SENSE MEDICAL ADVISER. 
1712. Treatment. For a proper treatment of these 
ulcers, the reader is referred to that suggested when considering 
the subject of ulceration, on pages 742 and 743. The course 
there advised has proved very successful. I cannot too strongly 
condemn the practice so much in vogue at the present day, of 
indiscriminately burning with strong caustics, every form of 
uterine ulcer, regardless of the condition of the general system. 
Ulcers of the womb are amenable to the same physiological laws 
which govern the healing of ulcers in other parts of the system. 
It is irrational practice to repeatedly cauterize them, expecting 
thereby to promote healing, while the system is vitiated and the 
vitality far below the standard of health. Enrich the blood, tone 
up the system, keep the ulcers cleansed as suggested, and they 
will generally heal. Caustics many times aggravate irritability 
and interfere with nature in her healing processes. Ladies 
should not unnecessarily submit to exposure of their persons for 
the purpose of having the womb burned with strong caustics. If 
they perseveringly employ the treatment which I have suggested, 
other local treatment will rarely be found necessary. This mod- 
ern warfare which the profession are waging upon the unoffending 
Avomb, is a most irrational practice ! Our grandmothers got 
along very well without exposing themselves to the humiliation 
and tortures of this new-born empiricism. I would not wish to 
be understood as undervaluing or denying the necessity, in rare 
cases, of examinations of the uterus, nor as unappreciative of the 
aid afforded in such investigations by the speculum, and the 
beneficial effects of local applications made directly to the womb 
through that instrument. What I affirm is, that such examin- 
ations and applications are, in the practice of most modern phys- 
icians, made unnecessarily frequent. 
TUMORS OF THE UTERUS AND OYARIES. 
1713. The uterus is ofttimes the seat of morbid growths of 
tissue, called tumors, which are sometimes mistaken for an en- 
largement of that organ, due to pregnancy. These vary in size 
from a grain of shot to that of the entire uterus at the seventh 
or eighth month of pregnancy. In texture they are either fib- 
rous, vascular, cancerous, gelatinous or glandular. Sometimes 
but one is present, in other cases they appear in great numbers. TUMORS OP THE UTERUS AND OVARIES. 
763 
1714. Polypus. This is the most common form of uterine 
tumor and appears in both married and unmarried women. 
Polypi are outgrowths of the uterine tissue, and may be either 
of glandular, mucous or fibrous texture. The cystic, or glandu- 
lar polypi, are soft, pearl-colored bodies, attached to the mem- 
brane of the neck of the uterus. These species of polypi are 
sessile, that is they adhere directly to their point of origin, with- 
out the intervention of pedicel or stem. Their existence is 
indicated by a profuse hemorrhage. They are easily desti’oyed, 
sometimes even by the dilation of the neck of the uterus, pre- 
paratory to examination. Mucous polypi originate in the lining 
membrane of the upper pai-t of the uterus, but their appearance 
is very rare. Fibrous, or more properly speaking, fibro-cellular 
polypi, ai’e more frequently met with than any other species of 
this variety of tumor. They are attached to the uterine wall by 
a small pedicel or stem. A fine illustration of this variety is 
given in Fig. 26, Colored Plate IY, the tumor being represented 
as it appears after being expelled from the uterus, from the 
mouth of which it is suspended by its pedicel, which remains 
attached to the inner surface of the womb. The local symptoms 
of uterine polypus are, pain, hemorrhage and leucorrhoea. The 
constitutional symptoms are, prostration, anaemia and hectic 
fever. 
1715. Treatment. Medicines are of no use in the treat- 
ment of uterine polypi. They are, however, generally very 
readily removed by surgical operation. 
1716. Fibrous Tltmors. These are morbid growths 
of tissue, identical in structure with that of the walls of the 
uterus. The celebrated Paget defines these tumors as fibrous 
growths invested with a capsule of fibro-cellular tissue so pecu- 
liarly dry and loose that when cut, the contents escape. It is 
often difficult to distinguish between fibrous polypi and fibrous 
tumors proper. The only apparent difference is that the latter 
are discontinuous with the membranes of the uterus, being con- 
nected therewith by its capsule, while the former are continuous 
with the uterine membrane. I have sometimes found it difficult 
to distinguish between them, after a careful examination with 
the most perfect instruments. The attendant symptoms and the 
position of the morbid growth, is the surest indication of the 764 
COMMON SENSE MEDICAL ADVISEII. 
species to which the tumor belongs. Thus, a polypus is always 
accompanied by profuse hemorrhage, while no such symptom 
attends the development of a fibrous tumor. Again, a fibrous 
tumor is almost invariably situated between the uterus and rec- 
tum. Owing to this fact, it is often mistaken for retroversion of 
the uterus, and vice versa. Numerous cases of this species of 
tumor have been brought under my observation and treatment. 
Having procured the most perfect and highly approved instru- 
ments for the examination and removal of these tumors, I have 
generally been successful in relieving my patients. 
1717. Ovarian Tumors. Tumor is the most common 
form of ovarian disease. It generally consists of the develop- 
ment of a sac (sometimes of several) within the ovary, varying 
in size “from that of a pea to a large sac containing many gal- 
lons of fluid.” Pathologists generally concur in regarding these 
cysts or sacs, as morbid growths or dilatations of the Graafian 
vesicles. Their contents vary in color and consistency from a 
light yellowish, watery fluid, to a turbid, ropy substance, tinged 
with blood. They also contain solid matter, hence the term 
“ compound tumor.” A very mysterious and interesting variety 
of ovarian tumor is termed dermoid cyst and contains hair, par- 
ticles of bone, and even rudimentary teeth. That these tumors 
are not due to conception, is proved by the fact that they are 
sometimes found in young children. 
1718. Ovarian tumors generally occur before the age of forty 
and their growth is very rapid. Menstruation becomes irregular, 
and in the latter stage of the disease is entirely suppressed. As 
the tumor develops it becomes softer, and the uterus is ante- 
fleeted; there is generally no difficulty in voiding the urine, 
but the general health is seriously affected. 
1719. Treatment. The medical treatment of ovarian 
tumors, or dropsy of the ovaries, has been faithfully tested and 
found to be ineffectual in dissipating these accumulations. Sur- 
gery offers the only reliable means of cure at our command. 
Those methods which, after a large experience, are regarded by 
the Faculty of the World’s Dispensary as the most reliable pro- 
cedures for the removal of ovarian tumors, are tapping, drain- 
age, injection of the sack, partial excision and ovariotomy, or 
the complete extirpation and removal of the tumor. Each of DISORDERS INCIDENT TO PREGNANCY. 
765 
these operations possess certain advantages in particular cases. 
Ovariotomy, when practicable and skillfully performed, is to be 
preferred. This should not be undertaken without due delibera- 
tion; for while in many cases it offers the only chance for saving 
life, yet it is a formidable operation attended by dangers, even 
when most skillfully performed. These considerations, how- 
ever, while they have their weight, I do not consider as sufficient 
to deter me from operating as a last resort. 
1720. While some women will pass through the wrhole period 
of pregnancy without inconvenience, others will suffer from va- 
rious sympathetic disturbances, as morning sickness, loss of 
appetite, constipation, diarrhoea, headache, “ heart-burn,” faint- 
ing fits, difficult breathing, and sometimes convulsions. A strong 
nervous sympathy exists between the uterus and every part of 
the system, and this sympathy is greatly intensified by preg- 
nancy, and is the cause of the distressing symptoms above 
mentioned 
DISORDERS INCIDENT TO PREGNANCY. 
1721. Treatment. With proper treatment, most of these 
ills can he obviated and the patient made comfortable. By the 
moderate use of such a nervine and uterine tonic as my Favorite 
Prescription, this nervous irritability may be controlled or sub- 
dued, and its disagreeable symptoms thus avoided. 
When the female believes herself to be pregnant, she should 
avoid all compression of the waist and abdomen. For this reason 
tight clothing, stays or corsets, must be discarded. She should 
also carefully regulate her diet, selecting that which is most 
nutritious and easiest of digestion. Sexual intercourse should be 
avoided, for although commonly indulged in, and many times 
with impunity, yet it is liable to be followed by distressing 
symptoms, as well as by some defect in the mental or physical 
organization of the offspring. 
The nausea which occurs in the morning may generally be 
avoided by partaking of a little light food and a cup of tea or 
coffee before leaving the bed. If vomiting occur, and the ejected 
matter be very acid, carbonate of magnesia, some alkali with aro- 
matics, or charcoal, will be likely to afford relief. If constipa- 
tion or diarrhoea be experienced, the treatment suggested when 766 
COMMON SENSE MEDICAL ADVISER. 
considering those subjects in a preceding part of this volume, 
should be employed. Want of appetite, headache, or a ten- 
dency to convulsions, can be generally overcome by a persistent 
use of my Favorite Prescription, which should be taken in tea- 
spoonful doses, three or four times a day. Indeed, this valuable 
medicine is a mother’s cordial, and not only relieves the distress- 
ing symptoms so frequently attending the pregnant state, but 
also prepares the system for the ordeal of parturition (delivery). 
One or two bottles of this nervine and tonic, used previous to 
confinement, will, in many cases, save hours of terrible suffering, 
besides regulating the system, thus insuring a speedy recovery. 
I have received the heartfelt thanks of hundreds of grateful 
mothers for the inestimable benefit thus conferred. My Favorite 
Prescription is perfectly safe and harmless to use at all times in 
the doses above prescribed. 
DISEASES OF THE URINARY ORGANS. 
1722. Next, if not equal in importance, to the function of 
the liver is that of the kidneys, the province of which is to 
remove a large portion of effete and poisonous matter from the 
system. Morbid changes in the general system are quickly indi- 
cated by the characteristic urinary deposits, and if we know how 
to interpret these, they are of great importance in determining 
disease. (See Urinary Signs.) 
INFLAMMATION OF THE KIDNEYS. (Nephritis.) 
1723. This affection may be either acute or chronic. The 
acute form 'of the disease is usually caused by injuries, blows 
upon the back, strains, irritation from calculi, suppressed per- 
spiration, the employment of irritating diuretics, etc. 
1724. Tile Symptoms, of the acute form, are febrile 
indications, such as chills, hot, dry skin, thirst, quick, hard pulse, 
and a deep-seated, throbbing pain in the region of the kidneys, 
all of which soon become very severe. The urine is scanty and 
highly colored, and the bladder irritable; the patient is unable 
to lie on the affected side, and the distress is increased upon 
rising. There is pain extending down into the thigh, numbness 
and drawing up of the testicle, nausea, vomiting, flatulence and 
constipation. If the disease terminates by suppuration, chills DISEASES OP THE URINARY ORGANS. 
767 
will be experienced, and the pain over the kidneys will become 
very severe; there will also be numbness and weight in the 
affected side, and pus may appear in the urine. 
1725. Treatment. This should be energetic. Diuretics 
are harmful and must not be used. The bowels should be acted 
upon freely. A spirit vapor-bath should be given each day. It 
will produce sweating, which may be rendered continuous by ad- 
ministering moderate doses of my Compound Extract of Smart- 
Weed. The latter remedy, being a powerful anodyne, will also 
prove a valuable assistant in relieving the pain. Until the in- 
flammation is controlled, persist in the use of the tincture or fluid 
extract of aconite and gelseminum. Wet packs, as hot as can be 
borne, applied to the back will be beneficial. As soon as the in- 
flammation yields, give mild, soothing diuretics, as sweet spirits 
of niter, and commence an alterative course of treatment. Care 
should be taken not to induce a relapse by undue exposure. 
When the pain is intense, three grains of saltpetre, and one- 
fourth to one-half grain of opium, every two hours, will give 
relief. 
1726. Chronic Inflammation of the Kidneys. 
The causes of this affection are obscure, and it is seldom that 
an uncomplicated case is met with. The advent of this disease is 
slow, and generally attended by disease of the bladder or ureters. 
It may follow, however, as a sequence of the acute form. 
1727. Symptoms. There is weight and a dragging pain, 
more or less severe, in the region of the kidneys, and which at 
times is intense. The general health becomes impaired, there is 
headache and dyspeptic symptoms, the patient has no energy, 
and the skin is apt to be dry and harsh. The urine varies in 
quantity and color, sometimes scanty, at others profuse, some- 
times highly colored, at others very pale, and containing more 
or less abnormal substances. An absolutely correct diagnosis 
cannot be made except by microscopical and chemical exam- 
inations. (See Urinary Signs.) 
1728. Treatment. To a great extent this will depend 
upon the complications involved. The employment of the spirit 
vapor-bath once a week, or sufficiently often to keep the skin in 
a good condition, is a valuable auxiliary. An alterative course 
of treatment should be carried out by the daily use of one or 768 
COMMON SENSE MEDICAL ADVISER. 
two of my Pleasant Purgative Pellets, accompanied by moder- 
ate doses of my Golden Medical Discovery. It may be combined 
or alternated with some of those mild but efficient diuretics, a 
description of which is to be found in this work. Those of a 
tonic character should be selected, as buchu 560), pipsissewa 
561), gravel-plant (*![ 563), or stone-root (®[ 565). Harsh 
means are wholly inadmissible. 
BRIGHT’S DISEASE OF THE KIDNEYS. (Albuminuria.) 
1729. This affection may occur in an acute or chronic form, 
either of which is dangerous. The acute frequently appears as a 
complication or sequel of scarlet fever, diphtheria, cholera, 
typhoid fever, erysipelas or measles, and is sometimes developed 
by intemperance. This form is very rapid in its progress, and 
apt to destroy life by uraemic poisoning — the retention of urea 
in the system. 
1730. The Symptoms of the acute form are diminution 
or suppression of urine, dry skin, chills, thirst, pain in the loins, 
and general dropsy. Examination of the urine shows the pres- 
ence of albumen. Unless promptly relieved the patient usually 
dies from coma or convulsions. 
1731. Treatment. It is not expected that any person 
will be so rash as to attempt the management of this affection 
without the aid of the best medical skill that can be procured. 
1732. Chronic Form of Bright’s Disease. This 
form of the disease comes on with less rapidity than the former, 
is apt to continue for a considerable length of time, and under 
the usual modes of treatment it almost invariably proves fatal. 
The affection is characterized by degeneration of the kidneys. 
It is oftenest met with in males, and seldom occurs during early 
childhood or extreme old age. 
The causes are obscure. It may appear as a complication of 
chronic bronchitis, pulmonary affections, or constitutional syph- 
ilis. Intemperance furnishes a large share of the victims, and it 
is often met with among the poor, who are exposed to hardships 
and deprivations. Professor Clark has found it as a complication 
of chronic dysentery. 
1733. Symptoms. These generally appear so gradually 
that they excite but little or no concern, until the occurrence of DISEASES OF THE URINARY ORGANS. 
convulsions or dropsy. Frequently a puffy, watery condition of 
the face, particularly under the eyes, is first noticed, and the pa- 
tient may observe that his urine is diminished in quantity. There 
will be obscure pain or weakness in the back, loss of flesh, gen- 
eral debility, red, brown or dingy urine, drowsiness, and perhaps 
symptoms of heart disease. The patient becomes ansemic, the 
breathing is wheezy, accompanied by cough and expectoration. 
Stupor, apoplexy or convulsions occur as forerunners of a fatal 
termination. Microscopical and chemical examinations of the 
urine are the only reliable means of diagnosis, and should be 
repeatedly made. (See Urinary Signs.) 
1734. Treatment. Keep the skin in a healthy condition. 
Plenty of woolen clothing is necessary, and flannel or silk should 
be worn next to the skin. The diet should be nutritious, princi- 
pally albuminous, and pastries avoided. In addition to the sug- 
gestions given above, remedies must be judiciously selected by a 
physician skilled in the treatment of chronic diseases; Recent 
investigations are developing some remedies which promise to 
prove specific in arresting this heretofore incurable disease. (See 
Case II, page 426.) 
DIABETES. (Polyuria and Glycosuria.) 
1735. There are two essentially different varieties of this 
disease, one of which is called Diabetes Insipidus, or Polyuria, 
and the other Diabetes Mellitus, or Glycosuria. The first is 
characterized by an increase in the amount of urine excreted, and 
yields readily to the proper treatment. The second is charac- 
terized by an increased amount of urine containing sugar, and 
under ordinary treatment is generally fatal. 
The causes are obscure, and therefore not very well understood 
by the profession. 
1736. Symptoms. A notable increase of the quantity of 
urine excreted is the first symptom which attracts the patient’s 
attention. Frequently several quarts, or even gallons, of urine 
are daily excreted, and it is paler than natural. With this excess- 
ive discharge of urine, the patient experiences extraordinary 
thirst, and has an almost insatiable appetite, though at the same 
time he loses flesh and strength. The tongue may be either 
clammy and furred or unnaturally clean and red. The bowels 770 
COMMON SENSE MEDICAL ADVISER. 
become constipated, a peculiar odor is observed in the patient’s 
breath and exhales from his body. The skin becomes harsh, 
dry and scurfy. There is dizziness, headache, dejection, lassi- 
tude, and not unfrequently cataract is observed in one or both 
eyes. The intellect is blunted, and as the disease progresses 
the emaciation and debility increase, and pulmonary diseases 
develop; or, perhaps, an uncontrollable diarrhoea sets in, and the 
patient dies from exhaustion. 
1737. The Treatment in this, as in other obscure 
affections, has generally been empirical and unsatisfactory. The 
function of the skin should be maintained by the use of the 
spirit vapor-bath. 
1738. Great attention should be paid to the diet, which 
should be highly nutritious, but any thing of a sweet or starchy 
nature must be avoided. The following articles are wholesome 
and afford sufficient variety, viz: of animal food — beefsteak, 
game, poultry, fish, eggs, cheese, cream, butter; of vegetables 
— spinach, dandelion greens, turnip tops, water-cresses, lettuce, 
cellery and radishes; for drinks — tea, coffee, claret, water, 
brandy and water, beef-tea, mutton-broth, or water acidulated 
with tartaric, nitric, citric, muriatic, or phosphoric acid. The 
forbidden articles are oysters, crabs, lobsters, sugar, wheat, rye, 
corn or oatmeal cakes, rice, potatoes, carrots, beets, peas, beans, 
pastry, puddings, sweetened custards, apples, pears, peaches, 
strawberries, currants, etc., also beer, sweet wines, port, rum, 
gin or cider. We have many medicines which produce specific 
effects in this disease, enabling us to treat it with greatly in- 
creased success; but the treatment has to be varied so much to 
suit individual cases, that it would be useless for us to attempt 
to instruct the non-professional in prescribing for themselves. 
URINARY DEPOSITS. 
1739. In health the urine holds in solution certain substances, 
which have a definite relation to each other. In disease the 
proportions are subject to numerous changes, some ingredients 
being diminished and others increased. Sometimes the changes 
are so great that the urine can no longer hold the substances in 
solution, and they are precipitated in the form of gravel. These 
changes bear a well-defined relation to disease, and when correctly DISEASES OF THE URINARY ORGANS. 
771 
understood, inform us of the condition of the system much better, 
and often much sooner, than we could ascertain it in any other 
way. To determine the character, extent and indications, of these 
urinary changes, we must have recourse to thorough chemical 
and microscopical examinations. Numerous illustrations of these 
deposits, as they appear under the microscope, may be found in 
the “ Thoughts Addressed to Invalids,” in the concluding part 
of this volume. A great variety of these changes may occur, to 
all of which I have devoted the most careful and earnest atten- 
tion. At the World’s Dispensary, urinary examinations form a 
prominent feature of the methods by wdiich we distinguish dis- 
ease, and to this fact I attribute much of my success in correctly 
understanding and treating urinary affections. 
GRAVEL. 
1740. When the solid constituents of the urine are increased 
to such an extent that they cannot be held in solution, or when 
abnormal substances are secreted, they are precipitated in small 
crystals, which, if minute, are called gravel, and may be passed 
through the urethra. When of larger size, they are termed 
calculi, or stones. When these substances are formed in the 
kidneys, they are termed renal calculi, and if in the bladder, 
vesical calculi. There are several varieties of gravel, each de- 
pending upon different conditions of the system for their forma- 
tion. The two prominent varieties are the red, or uric acid 
gravel, and the white, or phosphatic gravel. 
1741. Symptoms. When the deposits are in the kidneys, 
there will be pain in the back and loins, occasionally cutting and 
severe; sometimes it will dart down the course of the ureter to 
the bladder, and perhaps extend to the thighs. When the de- 
posits are in the bladder, there is frequent desire to urinate, wTith 
a bearing down, straining pain; also a sensation as of cutting or 
scratching along the urethra during urination. In the male, 
intense pain is often experienced at the end of the penis. J3y 
passing the urine in a vessel and allowing it to settle, a gravelly 
deposit will be seen. It is generally of a red or white color, and 
the particles vary materially in size. 
1742. Treatment. The general systemic derangements 
indicated by these urinary deposits, must be attended to, in order 772 
COMMON SENSE MEDICAL ADVISER. 
that a permanent cure may be effected. Nutrition is at fault 
and some of the excretory organs are not properly performing 
their functions, or perhaps some portion of the body is being too 
rapidly wasted. 
In order to treat these cases rationally and successfully, it is 
first necessary to ascertain by microscopical and perhaps chemi- 
cal examination, the character of the deposit. By such exam- 
ination the exact condition of the system, which gives rise to 
these abnormal products, may be positively determined, and the 
remedies to be employed will be indicated. (See Urinary Signs.) 
As the non-professional are not supposed to be qualified to con- 
duct such examinations, it would be a waste of space for me to 
suggest specific treatment for the different varieties of gravel. 
STONE IN THE BLADDER. (Vesical Calculi.) 
1743. If the gravelly deposits already described are not ex- 
pelled with the urine, they form a nucleus upon which layer 
after layer is deposited, thus developing stone in the bladder. 
This affection is more frequently met with in men than in women, 
and occurs, in the majority of cases, prior to the thirtieth year. 
1744. Symptoms. There is pain in the region of the 
bladder, which is aggravated by any jolting motion, and which 
immediately after urinating, is excessively severe. In males there 
is often very acute pain at the end of the penis. In children the 
pain and uneasiness in this part is often so great, that they grasp 
and pull the penis violently. In urinating, the stream is some- 
times suddenly arrested, when by a change of position it again 
flows freely. These symptoms are not to be accepted, however, 
as conclusive evidence of the existence of stone in the bladder. 
The surgeon, by exploring the bladder with a steel sound, de- 
tects stone with certainty, an audible click being produced when 
the sound comes in contact with it. 
1745. Treatment. Tile formation of stone may be pre- 
vented in some persons subject to this disease, by appropriate 
treatment, but after the stone is once developed, it is question- 
able whether any treatment except a surgical operation, will 
prove effectual. A belief that calculi can be dissolved in the 
bladder, has been entertained by some distinguished practi- 
tioners, but the attempts at accomplishing this have not been DISEASES OP THE URINARY ORGANS. 
773 
encouraging. The surgical means employed are various. In some 
cases the stone may be crushed by an instrument called the lith- 
otrite, being introduced into the bladder through the previously 
dilated urethra, and the pieces afterwards removed through this 
canal; this process is called lithotripsy. Another method con- 
sists of cutting into the bladder and removing the whole stone. 
This method is called lithotomy. The operation of lithotomy is 
variously modified by different surgeons. The method which I 
regard as the least dangei’ous, and the one which has been prac- 
ticed with the greatest success when the stone has not been of 
extraordinary size, may be termed the modified median operation. 
The operator, having made a perpendicular incision in the medi- 
an line of the perineum, between the root of the penis and the 
rectum (see Fig. 107, Page 218), cuts down upon and opens the 
urethra in front of the bladder. When the opening in the urethra 
is nearly an inch in length, the knife is laid aside and the surgeon 
introduces his forefinger and very gradually dilates the undivided 
portion of that canal (the urethra) and the neck of the bladder, 
until the opening is sufficiently large to admit a pair of forceps, 
by which the stone may be withdrawn. If the stone be too 
large to permit of extraction through the undivided portion of 
the urethra, it may be crushed with a lithotrite and then removed 
in pieces. This is seldom necessary, however, for I have found, 
contrary to the general teaching, that if time be taken in which 
to dilate the canal to its full capacity, stones measuring an inch 
or more in diameter may be removed entire, without lacerating 
the canal. Surgeons have generally performed this operation 
hastily, and hence many times have failed to remove stones 
which might readily have been extracted if the urethra and neck 
of the bladder had been gently and cautiously dilated by a semi- 
rotary movement of the finger. The advantage of this method 
over the lateral operation, which is generally practiced by 
surgeons in this country, is that it avoids cutting the prostate 
gland (see Fig. 107, Page 218), does not produce so great a 
shock to the system, is not so liable to be followed by urinary 
infiltration of the surrounding tissues, thus causing inflammation 
and even suppuration, and is attended with very little or no 
hemorrhage, while the ordinary operation sometimes occasions 
exhaustive bleeding. An operation similar to that already 774 
COMMON SENSE MEDICAL ADVISER. 
described, may be more readily practiced upon the female, and 
is followed by equally favorable results. 
INFLAMMATION OF THE BLADDER. (Cystitis.) 
1746. The acute form of this affection is not of very frequent 
occurrence, except in connection with gonorrhoea. That portion 
of the bladder nearest the neck, is oftenest involved. 
1747. Symptoms. There is intense pain in the region of 
the bladder, sensitiveness to pressure, and sometimes pain in the 
perineum, testicles and loins. There is almost a constant desire 
to urinate, but the act is accompanied with severe pain and a 
bearing down sensation. At first the urine is apt to be scanty 
and highly colored, but soon becomes red, perhaps bloody, and 
finally loaded with muco-purulent matter. There is generally 
considerable febrile disturbance, which is sometimes severe. 
1748. Treatment. Absolute rest is a primary essential. 
A spirit vapor-bath should be given, and the sweating continued 
by administering my Extract of Smart-Weed. It is a good ano- 
dyne and will relieve the pain. Hot fomentations over the region 
of the bladder, are beneficial. As a brisk cathartic, full doses of 
my Pleasant Purgative Pellets should be given at an early stage 
of the disease. The thirst may be allayed by cooling drinks. 
Give a pretty large dose of aconite and gelseminum every hour. 
When the acute symptoms disappear, mild, unirritating diuretics 
may be employed, as an infusion of stone-root, marsh-mallow, 
water-melon or pumpkin seeds. 
1749. Chronic Inflammation of the Bladder. 
This affection, which is also called cystirrhoea or catarrh of the 
bladder, is an inflammation of the mucous lining of this organ. 
It may occur at any period of life, but is oftenest met with in 
the aged, and is frequently associated with Stune obstruction to 
the flow of urine. 
1750. Causes. It may arise from colds, injuries, irritating 
diuretics, injections, extension of disease from the kidneys or 
adjacent organs, intemperance, severe horseback riding, recession 
of cutaneous affections, gout, rheumatism, etc., but its more fre- 
quent causes are urethral stricture, enlarged prostate gland, 
gravel, and gonorrhoea. It is also caused by an habitual reten- 
tion of the urine, and is ofttiines a result of masturbation. DISEASES OF THE URINARY ORGANS. 
1751. Symptoms. There is an uneasy sensation in the blad- 
der, heaviness, and sometimes pain and weakness in the back and 
loins. The urine becomes scanty, and though the calls to void it 
are more frequent, it is passed with difficulty. If allowed to 
stand, the urine deposits more or less mucus, which may be con- 
founded with semen. As the discharge progresses, the quantity 
of the mucus is increased. It is very viscid and adheres to the 
sides of the vessel so that when we attempt to pour it out, it 
forms long, tenacious, ropy threads; sometimes there is so much 
of it that on exposure to cold the whole mass becomes semi- 
solid, resembling the white of eggs. The excreted urine is 
alkaline, acrid, exhales a strong odor of ammonia, and soon be- 
comes exceedingly fetid. Sometimes the urine becomes so thick 
that it is with great difficulty it can be expelled from the blad- 
der. Nocturnal emissions, impotency and loss of sexual desire, 
are apt to ensue. Occasionally there will be a spasmodic con- 
traction of the bladder,with straining and a sensation of scalding 
in the urethra, and sometimes on attempting to urinate, the 
patient finds that he is unable to do so at all. 
1752. Treatment. Proper attention to the rules of hy- 
giene, is essential to a cure. We must ascertain the cause, if 
possible, and prevent it from perpetuating the disease. The 
bowels should be kept regular, and if costive, a small dose of my 
Purgative Pellets should be daily administered, which will prove 
very beneficial. The skin should be kept healthy and vigorous 
by frequent baths; the spirit vapor-bath may be beneficially em- 
ployed, if the skin be dry and husky. The causes and conditions 
involved in different cases, are various, and demand correspond- 
ing modifications of treatment; hence it is useless for me to 
attempt to teach the non-professional how to treat this complex 
disease. I have succeeded in curing many very severe cases, 
without seeing the patient, being guided in my prescriptions by 
the indications furnished by microscopical and chemical examin- 
ations of the urine. (See Urinary Signs.) 
INCONTINENCE OF URINE. (Enuresis.) 
1753. Two varieties of this annoying affection are observed. 
In one there is inability to retain the urine and it escapes when 
the patient is laughing, sneezing, coughing, etc., or it continues 776 
COMMON SENSE MEDICAL ADVISER. 
to dribble away without interruption. This variety is generally 
due to weakness of the generative organs, paralysis of the blad- 
der, pressure from tumors, falling of the womb, pregnancy, 
masturbation, excessive venery, etc. The other affection, which 
is most common to children, is characterized by nocturnal incon- 
tinence, or “ wetting the bed.'1'1 In either case the urine is dis- 
charged involuntarily. 
1754. Treatment. This must, of course, be governed 
by the cause. If due to weakness of those parts or paralysis of 
the neck of the bladder, treatment suitable to those conditions 
must be instituted; if to tumors, a surgical operation will prob- 
ably be necessary; if it is caused by falling of the womb, 
employ treatment elsewhere suggested for that affection; if 
induced by venereal excess or masturbation, the cause should be 
avoided and proper tonic treatment be resorted to in order to 
strengthen the debilitated parts. 
1755. When the affection occurs in children and is character- 
ized by wetting the bed, the cause must, if possible, be ascer- 
tained and removed. If due to worms, give anthelmintics 
487); if to irritation of the bladder, the treatment recom- 
mended for that complaint is appropriate; if to spinal irritation, 
bathe the back, loins and genitals with cold water before going 
to bed. Establish a habit in the child of waking at certain 
hours to evacuate the bladder and compel him to avoid hearty 
suppers and to sleep on a hard bed; give him one of my Purgative 
Pellets every night. If they act too freely on the boAvels give 
one every other night. If he is anaemic administer five drops of 
the tincture of iron three times a day. 
The causes are sometimes so obscure that they require the 
investigation of a skillful physician, to ascertain them and direct 
the proper treatment 
ENLARGEMENT OF THE PROSTATE GLAND. 
1756. Affections of the prostate gland are of more frequent 
occurrence than is generally supposed, especially among persons 
advanced in years. All the affections of this gland generally 
begin with, or terminate in, enlargement. This disease exerts a 
great influence upon the genitals, occasioning a diminution of 
sexual power and desire, often amounting to complete impotency. DISEASES OE THE URINARY ORGANS. 
1757. Causes. One of the most frequent causes is abuse 
of the genital organs. Masturbation, excessive coition, licen- 
tiousness (particularly during advanced age), gonorrhoea, strict- 
ure, inflammation of the neck of the bladder, horseback riding, 
the harsh or improper employment of the catheter or bougie, 
intemperance, retaining the urine in the bladder for a long time, 
and in short anything that is capable of producing irritation of 
this gland is liable to cause its enlargement. 
1758. Symptoms. Sometimes the disease may exist for 
years without causing any trouble, or even attracting the atten- 
tion, until a sudden retention of the urine is experienced. Gen- 
erally, one of the earliest symptoms observed is, that the urine 
flows with less readiness than in former years, and more force is 
required to produce the ordinary sized stream, or to project it 
from the body. The calls to urinate are more frequent, the 
urine flows slowly, and there is a disagreeable feeling after it is 
voided. As the disease progresses an uneasy sensation is expe- 
rienced in the perineum, about the pubes, with weight and bear- 
ing down; oftentimes there is a sensation as of a foreign 
substance in the rectum, and piles are developed. In urinating, 
the patient is obliged to strain and assume different postures to 
favor the flow, and in some cases the urine cannot be passed at 
all, without the aid of the catheter. The constitution suffers 
and grave symptoms ensue. The powers of life fail, the gland 
suppurates, and hemorrhage or uraemic poisoning terminates the 
patient’s existence. When the symptoms are insufficient to form 
a correct diagnosis, it may readily be determined by passing the 
fingers into the rectum, or by the employment of the catheter. 
1759. Treatment. The patient should be cautioned not 
to retain his urine too long, as by so doing he favors the dis- 
ease. He should also be instructed in the use of the catheter, so 
that he may obtain speedy relief whenever necessary. Care 
should be taken to avoid all irritation of the urinary organs, 
and an alterative course of medicine should be carried out upon 
the same principle and for the same purpose that it is employed to 
remove other species of enlargements. Use my Golden Medical 
Discovery, to each bottle of which may be added half an ounce 
of bromide of potash or muriate of ammonia, and at the same 
time take a sufficient number of the Pellets to keep the bowels 778 
COMMON SENSE MEDICAL ADVISER. 
regular. This is very essential, for constipation is a serious com- 
plication. If the general health suffers, it must be built up with 
tonics, as iron, quinine, nux vomica, etc. If there be consider- 
able irritability of the neck of the bladder and the gland, in 
addition to the Discovery, appropriate doses of poison hemlock 
(T 482) may be administered. An injection, made by dissolving 
one grain of the solid extract of the latter, in a tablespoonful of 
warm water, should thrown into the urethra three or four 
times daily. Care should be taken to throw it back as far as the 
prostate, and by pressing upon the penis with the thumb and 
finger, hold the injection in the urethra a little time. As to the 
kind of catheter to be used, both the gum elastic and silver are 
appropriate. I think the silver one is preferable for the prac- 
titioner, but when employed by persons unskilled in their use, 
less harm is apt to be done with the gum elastic. The above 
constitutes all the treatment which the patient can apply, and 
indeed it is attended with extraordinary success. I have, how- 
ever, cured a great many persons by other means, when the 
above treatment failed, but the measures which I employ are of 
too complicated a character to be of any service to the non-pro- 
fessional reader. 
VENEREAL DISEASES. (Gonorrhoea and Syphilis.) 
1760. Regarding the origin and nature of these maladies, a 
great diversity of opinion prevails. In some form they have 
afflicted humanity from the earliest times of which we have any 
record. Among the early writers who refer to them we may 
mention Herodotus and Hippocrates, thus clearly proving that 
these diseases were known to the ancients; for several centu- 
ries they have been exceedingly prevalent. It is not fully 
determined whether there are one or more distinct poisons which 
produce the various venereal diseases. Some medical writers 
claim that there is but one poison, and that the varieties of 
venereal affections are simply modifications of one disease, while 
others believe that these several disorders are due to different 
poisons, and, therefore, are distinct diseases. 
The celebrated John Hunter believed that there was but one 
venereal poison, and prior to 1857, was supported in this view by 
the renowned Ricord. Sigmund, Yon Baerinsprung, Rollet, VENEREAL DISEASES. 
779 
Diday, Michaelis and others who have thoroughly investigated 
this subject are divided in their opinions, while the results of Dr. 
Marston’s late researches are in favor of the unity doctrine; in 
my own experience circumstances have occurred which can only 
be explained upon the latter theory. 
1761. This theory supposes that when the poison comes in 
contact with the unbroken surface of the mucous membrane, it 
produces gonorrhoea or clap; and when it comes in contact with 
an abraded surface it produces syphilis or pox. On the contrary 
those who advocate the plurality hypothesis affirm that gon- 
orrhoea and syphilis are produced and perpetuated by distinct 
poisons coming in contact with either mucous or abraded 
membranes. 
1762. Another subject of dispute is whether constitutional 
infection is ever caused by clap or soft chancre (chancroid). 
The advocates of the former theory claim that the system may 
be infected from either clap, chancroid or chancre, while those 
who believe in the plurality theory hold that chancre (hard 
chancre) is the only source of infection. However, I am in- 
clined to the belief that constitutional infection may, and does 
sometimes, result from clap and soft chancre, as well as from 
what is known as the true, hard, Hunterian or infecting chancre. 
Therefore, so long as we are liable to error, it is best to be on 
the safer side; hence we should treat every case of this kind as 
if constitutional infection were certain to occur, and take the 
proper steps for its prevention. The importance of such a 
course is illustrated by facts which are daily coming under my 
observation. Individuals have been lulled into fancied security 
by their medical advisers, have rejoiced at the disappearance of 
the local symptoms and neglected to pursue the only treatment 
—constitutional—upon which safety depends. But the disease 
still lurks in the system, gradually increases in strength and vir- 
ulence, until finally, the deceived victim is overwhelmed by a 
multitude of affections collectively termed secondary syphilis. 
1763. Whichever theory be correct, it is certain that ail 
venereal disease is the result of contagion, the virus being com- 
municated by actual contact. Laying aside all prejudice against 
one theory or the other, it is proper to say here that, notwith- 
standing the most thorough investigation and criticism, scientists 780 
COMMON SENSE MEDICAL ADVISER. 
have failed to discover a law which completely governs the action 
of this virus. We cannot go back to the origin of venereal dis- 
ease, for it is involved in obscurity; but doubtless it arose from 
promiscuous and excessive venery, under certain conditions which 
favored its development. 
1764. Clap (Gonorrhoea). This form of venereal disease 
is a specific inflammation of the lining membrane of the urethra, 
or water-passage. When it occurs in females, it affects the 
mucous membrane of the vagina, and may extend to that of the 
urethra. It is communicated from one person to another by 
sexual intercourse. It is very rarely imparted in any other man- 
ner, though it can be communicated by the least quantity of virus 
coming in contact with any of the mucous membranes. Some- 
times sexual intercourse with a female afflicted with leucorrhcea, 
produces a disease in the male, which is apparently similar to 
gonorrhoea. Gonorrhoea is usually developed in from three to 
eight days after exposure to the infection. Sometimes the in- 
flammation is limited to the mucous membrane covering the glans 
penis, and is then called Balanitis. 
1765. Symptom*. In from two to ten days after infection 
the patient experiences an itching and uneasy sensation in the 
urethra, the mucous membrane appears unusually red, the lips of 
the urethral orifice are swollen, a scalding sensation is experi- 
enced in voiding the urine, and there is a profuse discharge of 
thick, yellow matter. The head of the penis is swollen and the 
stream of urine divides. The warmth of the bed causes trouble- 
some erections; as the inflamed condition of the urethra will not 
permit extension, the penis has a crooked appearance, curving 
downward, and is exceedingly painful (chordee). If the disease 
be not cured in its early stages, it may become complicated with 
inflammation of the bladder, enlargement of the glands in the 
groin, stricture of the urethra, or with swelling and inflammation 
of the testicles. The inflammation may extend to the whole 
lining membrane of the bladder, causing a frequent desire to 
urinate. If cleanliness be not observed, the irritating discharge 
(by contact with the surface) produces warts, or, being re-absorbed 
into the system, occasions fever, rheumatism, eruptions, etc. If 
the patient be a female, the same length of time will elapse be- 
tween the exposure and the appearance of the local symptoms. VENEREAL DISEASES. 
781 
She will experience an itching or uneasiness in the urethra, a 
sense of fullness in the vagina, and in a day or two there will be 
a scalding sensation in voiding the urine, chills and feverish symp- 
toms — evidences of a general disturbance. The lining of the 
urethral orifice, and that of the vagina and outer lips, is red and 
swollen, while the inner lips are thickened. If the treatment be 
not promptly applied, the constitutional disturbance increases, 
the local inflammation becomes more intense, and there is a 
copious discharge of thick, yellow, poisonous matter. The symp- 
toms being similar to those of leucorrhoea and menstruation, she 
does not seek relief until they have become violent. The in- 
flammation may extend to the womb and Fallopian tubes, and 
the ovaries be sympathetically affected. The urethra and even 
the bladder may become involved, in which case the symptoms 
are essentially the same as in the male. 
1766. Treatment. The use of injections in the urethra 
(of the male) and vagina (of the female) is very beneficial In 
the early stages of the disease I have found an injection, com- 
posed of one drachm of the tincture or fluid extract of aconite 
leaves and an ounce of water, to be very efficacious. It will usu- 
ally subdue the pain and inflammation in from two to four days. 
Its use should then be discontinued and a solution of three grains 
of permanganate of potash to an ounce of water, employed. 
The general treatment should be commenced by administering 
the tincture of staphisagria, two drachms of which should be 
added to four ounces of water, and a teaspoonful given every 
four hours. If this tincture be not readily obtained, take my 
Golden Medical Discoveiy, to each bottle of which add two 
ounces of spirits of nitre and three drachms of the fluid extract 
of gelseminum. Of this mixture take a teaspoonful every four 
hours. An ounce of the acetate of potash may be substituted 
for the nitre. The Purgative Pellets will be found useful in 
keeping the bowels regular. To relieve and prevent painful 
erections (chordee) take from ten to fifteen grains of bromide 
of potash, dissolved in an ounce of camphor water, before going 
to bed. Fomentations applied to the external genital parts, are 
beneficial. In consequence of constitutional peculiarities, the 
above treatment may not prove successful — in which case a 
skillful physician should be consulted. 782 
COMMON SENSE MEDICAL ADVISER. 
GLEET. (Blennorrhcea.) 
1767. This disease is indicated by a chronic discharge of 
mucus from the urethra. It is the result of badly-treated clap, 
or repeated attacks of the same, in persons of a scrofulous dia- 
thesis or depraved constitution. It is sometimes perpetuated by 
stricture or disease of the prostate gland. All the violent symp- 
toms of clap subside, leaving the walls of the urethra thickened. 
The chronic discharge debilitates the system, and is a constant 
source of annoyance. There are apt to be fibrous deposits, which 
narrow the urethral passage and interfere with the flow of the 
urine; or there may remain a granulated condition of the lining 
of the urethra. The discharge is usually white, sometimes pro- 
fuse, and at others scarcely perceptible. Any irritation makes it 
yellow. Alcoholic stimulants, sexual intercourse, violent exercise, 
exposure to sudden changes of temperature, etc., are followed by 
a scalding sensation on urinating, a purulent discharge, and all 
the symptoms common to the acute stage of the disease, thus 
making it as contagious as in the beginning. In the female, the 
symptoms of this disease are very similar to those of leucorrhoea, 
and only a knowledge of the previous history of the case can 
enable us to distinguish between them. This affection is apt to 
be very intractable, hence it should always be treated by a 
physician who has had large experience in the management of 
chronic maladies. 
SWELLED TESTICLES. (Epididymitis.) 
1768. This is a frequent complication of gonorrhoea, especi- 
ally in the latter stages of that disease. It is caused by the 
inflammation extending to the testicle, and is liable to follow the 
use of strong injections. The left testicle is oftenest affected, 
and the development of the disease is attended by pain, swelling 
and more or less fever. The acute form sometimes becomes 
chronic, and the testicle remains enlarged, though the other 
symptoms are mitigated. 
1769. Treatment. To avoid irritating the affected parts 
the patient should assume the recumbent position and the tes- 
ticles be supported by a pillow or cushion. In the majority of 
cases warm applications are preferable to cold ones. For this VENEREAL DISEASES. 
783 
purpose a lotion, composed of one ounce of muriate of ammonia 
to a pint of water, will prove very beneficial. If the pain be 
severe, it will be necessary to apply and administer anodynes. 
As a liniment and sedative, my Compound Extract of Smart- 
Weed is not excelled. If the disease be not promptly arrested, 
and the enlargement reduced, there will be difficulty in effecting 
a cure. It is, therefore, necessary to employ a skillful and 
experienced physician. 
STRICTURE OF THE URETHRA 
1770. As we have before stated, this affection generally 
occurs as a sequel or complication of gonorrhoea, but it may be 
due to other causes. It is termed spasmodic or organic, accord- 
ing to its character. The former is not attended by pain, occurs 
suddenly, as suddenly disappears, and is caused by a spasmodic 
contraction of the circular muscular fibres of the urethra, while 
the latter is occasioned by a gradual deposition of lymph around 
the urethra. The deposited matter, becoming organized as a part 
of the tissues, causes a permanent diminution of the calibre of 
of the urethral passage. 
1771. Symptoms. The patient experiences difficulty in 
voiding urine, several ineffectual efforts being made before it 
will flow. The stream is diminished in size, of a flattened or 
spiral form, or divided into two or more parts, and does not flow 
with the usual force. 
1772. The treatment of stricture varies so much with the 
peculiarities of individual cases, and is generally so purely sur- 
gical in character, that it is useless for me to attempt to teach 
the non-professional how to apply it. A competent physician 
should be consulted by those suffering from this affection. 
POX. (Syphilis.) 
1773. With the exception of cancer, this is the worst of all 
diseases. Few persons have any idea of the extent to which it 
prevails. In its myriad forms it is sapping the sources of vital- 
ity and destroying beauty, vigor and manhood. When the 
system is once inoculated with syphilitic poison, unless the effects 
are promptly counteracted the disease continually increases in 
virulence, manifests itself in multifarious forms and may be 784 
COMMON SENSE MEDICAL ADVISEE. 
transmitted to posterity. One generation may escape, the dis- 
ease cropping out in the next, and those affected, being ignorant 
of its nature, allow it to progress uninterruptedly. By the 
ordinary treatment of this disease, with mercury and sarsapa- 
rilla, the outward signs may disappear for a time, but, sooner or 
later, they will return, and perhaps with greater intensity. Many 
skin affections are evidently traceable to syphilitic infection. No 
tissue of the body escapes the ravages of this dreadful poison. The 
bones and muscles are destroyed by its corroding influence, and 
the hydra-headed monster gloats on human misery and deform- 
ity ! The infected husband transmits the disease to his wife and 
its indellible impress is stamped upon the germ. An infected 
wife imparts it to her husband and child, or the infant may be- 
come infected through the milk of its nurse. It may also be 
contracted through impure vaccination, or in any manner by 
which the smallest quantity of virus is brought in contact with 
an abraded surface. 
1774. Symptoms. Three successive stages mark the 
progress of this disease, namely: the primary, secondary, and 
tertiary. During the primary stage, chancres or virulent ulcers 
occur at the point of infection, and the disease is purely local, 
while in the two latter stages it is constitutional. The period 
intervening between the time of exposure and the appearance of 
the local manifestation of the disease, will vary from one to 
eight days—seldom being longer. At first there is a little red- 
ness, then a pustule is formed, which soon breaks, leaving an 
open sore, usually located under the covering and near the bridle 
of the penis in the male, or on the external genital parts, in the 
vagina, or on the mouth of the uterus, in the female. The infect- 
ing or hard chancre is always single, and surrounded by a hard 
border. This variety is represented in Fig. 27, Colored Plate V. 
In this form, the local sore is small and usually unobserved until 
the virus enters the circulation and produces constitutional symp- 
toms. Of the soft variety of chancre, two or more frequently 
appear at the same time. They sometimes coalesce, cause con- 
siderable destruction of the tissues, but are not surrounded by 
a hard border. This variety is well illustrated in Fig. 28, Col- 
ored Plate Y. Fig. 24, Colored Plate IY, represents this form 
as it appears on the mouth of the womb. Plate V. 
Fi6.29. 
Fig 27 
Fig 28 
Fig 30 
Fig. 31 
Fig 32 VENEREAL DISEASES. 
785 
1775. After the local sores have existed for some time, little 
hard lumps are noticed in the groin, which enlarge and merge 
into one another until a blue tumor, called a bubo, is formed. It 
frequently attains a size as large as a goose egg and sometimes 
disappears in a few weeks; at other times it breaks and dis- 
charges, forming an open sore, which is healed with great 
difficulty. During the secondary stage of the disease an erup- 
tion of copper-colored spots may appear upon the face and 
body. The hair sometimes falls out, and the glands in the back 
of the neck enlarge, becoming very painful. In the course of six 
or eight months ulcers appear in the mouth and throat. They 
destroy the soft parts, as seen in Fig. 32, Colored Plate Y, which 
is a good representation of these sores. Syphilitic pains are ex- 
perienced in different parts of the system, harassing the patient 
at night. The eye is nowdiable to become affected. Inflamma- 
tion of the iris, a condition well represented in Fig. 31, Colored 
Plate Y, is a common complication. Lumps called nodes appear 
on the bones and finally ulcerate, causing decay and exfoliation. 
The bones of the shin, elbow and forehead are most frequently 
affected. A fine illustration of syphilitic ulceration over the 
superficial bones is given in Fig. 30, Colored Plate Y. 
Syphilitic catarrh, or ozoena, is a very common affection. 
Ulcers appear in the nose and destroy the surrounding parts— 
so that the nasal passages and mouth often form one cavity— 
presenting a hideous appearance. The body is disfigured by 
eruptions, some of which appear in clusters, while others are 
spread over the whole surface. In some cases they fester and 
break, and hard, thickened crusts are formed. They are exceed- 
ingly indolent and generally attended by itching. It is a pecu- 
liarity of these eruptions that one form often changes into another. 
Large morbid growths may appear about the arms or upon the 
external genital parts of the female, and sometimes elsewhere. 
These tumors are represented in Fig. 29, Colored Plate V. 
1776. Treatment. Under no circumstances can the 
patient experience greater necessity for skillful treatment than 
in this disease, hut, alas, how often is he duped by the promises 
of quacks, who assure a speedy cure. He swallows their useless 
drugs, only to find that his condition is but temporarily improved, 
if at all. By many practitioners of medicine bichloride of 786 
COMMON SENSE MEDICAL ADVISER. 
mercury (corrosive sublimate), iodide of mercury, and other 
kindred preparations, are regarded as the most efficacious reme- 
dies. It has, however, been clearly proved that this affection 
can be cured in less time by other agents. 
1777. In the primary stage, the treatment which should be 
early applied is as follows: thoroughly cauterize the sore, thus 
destroying its specific character. Nitric acid, nitrate of silver 
and chloride of zinc, are the most efficient caustics. The first is 
to be preferred, and should be applied as follows: dip a small 
pine stick in the acid, and after wiping off all superabundant 
liquid, apply it to every part of the sore. Afterwards apply a 
dressing of lint, saturated with a mixture composed of half a 
drachm of carbolic acid and an ounce of glycerine. At the end 
of a week, if the sore has not commenced to heal, the cauteriza- 
tion should be repeated. 
1778. Constitutional treatment is indispensable, and must be 
persisted in even when no visible trace of the disease remains. 
No matter in what form the disease manifests itself, or what the 
complications may be, the cure will mainly depend on the con- 
stitutional treatment. This will, however, be modified by 
circumstances, as individual peculiarities will necessitate changes 
in the management. 
The diet must be nutritious. The skin, liver and kidneys 
should be kept active, to favor elimination of the poison. Fre- 
quent bathing is beneficial, and the sulphur, acid, turkish or 
spirit vapor-baths are preferable. As constitutional treatment, 
my Golden Medical Discovery is an agent of inestimable value 
in this affection, although there are cases in which it may fail to 
effect a cure. It could not be expected that a remedy adapted 
to so many diseases, should be sufficiently powerful to eradicate 
in every instance, this terrible scourge. To accomplish such a 
result it would be necessary to introduce certain ingredients, 
which would render it harmful if misapplied, as it might be by 
non-professional persons. 
1779. The efficacy of the Discovery may be increased in 
severe or obstinate cases, by adding to each bottle from one- 
half to an ounce of the iodide of potassium. If the kidneys be 
torpid, instead of the iodide, the same quantity of the acetate of 
potassium may be added to each bottle. The bowels should be VENEREAX DISEASES. 
787 
kept regular; for this reason, as well as to increase the efficacy 
of the other remedies, small doses of my Purgative Pellets 
should be daily administered. They are powerfully alterative 
when taken in such small doses that they do not produce active 
purging, and their use should be continued for a protracted period. 
The treatment must be persisted in for a considerable length 
of time, before its beneficial effects will be apparent. If, for any 
reason, this treatment should fail, in consequence of constitu- 
tional peculiarities or extraordinary complications, a skillful 
physician should be consulted. In addition to the constitutional 
treatment already advised, some of the complications require 
special attention. 
Treatment of Buboes. To prevent suppuration, treatment 
must be instituted as soon as they appear. ' Compresses, wet in a 
solution composed of half an ounce of muriate of ammonia, three 
drachms of the fluid extract of belladonna, and a pint of water, 
are beneficial and should be continuously applied. The tumor 
may be discussed by painting it once a day with tincture of iodine. 
Eruptions. The treatment of these should be mainly constitu- 
tional. Perfect cleanliness should be observed, and the sulphur, 
spirit vapor or alkaline-bath, freely used. Good diet and the 
persistent use of alteratives will generally prove successful. 
The morbid growths (represented in Fig. 29, Colored Plate V) 
may be removed by the application of chromic or nitric acid. 
For Syphilitic Catarrh, employ the constitutional treatment 
already advised, and use Dr. Sage’s Catarrh Remedy. The nasal 
passages should also be cleansed, once a day, by a lotion com- 
posed of five or ten grains of permanganate of potash and a pint 
of water. 
Those secondary ulcers, which occur over the superficial bones 
can only be cured by the protracted use of the best alteratives 
458) and proper local applications. Cleanse the sore daily 
with Castile soap and warm water, and then apply a lotion com- 
posed of ten grains of carbolic acid and one ounce of glycerine. 
Whatever topical applications may be employed for any of the 
local manifestations of syphilis, the patient must never lose sight 
of the fact that his main reliance must be upon constitutional 
treatment. 
For the treatment of syphilitic iritis, see 1413. 788 
COMMON SENSE MEDICAL ADVISER. 
ABUSE OF THE MALE REPRODUCTIVE ORGANS* 
1780. A general idea of the relative size and position of the 
male reproductive organs may be obtained by referring to the 
illustration on page 218. It will be decidedly advantageous to 
study the anatomy of these organs, in order that their natural 
functions may be fully comprehended, and the disorders to 
which they are liable, more clearly understood. It is admitted 
that the abuse of the reproductive organs results in serious ner- 
vous, as well as general physical derangement, and ultimately 
destroys the health. It is, therefore, desirable to give special con- 
sideration to the essential parts of the male generative system, 
and most especially to the structure and office of the testicles. 
1781. The word testicle is derived from testiculus, the diminu- 
tive of testis, which signifies a “witness;” hence the testicles in 
man are evidences of virility, or the power of procreation. The 
testes are two small, glandular organs, situated in the scrotum, 
which is a pouch, or sack of skin, hanging beneath the root of 
the penis. Each testicle is of an oval form, and suspended by 
a vascular, nervous structure, called the spermatic cord. The 
function of the testes is to secrete sperm—semen — a vital, 
quickening fiuid, of a whitish color and peculiar smell. 
1782. Development of the Testicles in the 
Abdomen. The testicles, at an early period of intro-uterine 
life, are in the abdomen of the foetus, and directly beneath the 
kidneys. At the fifth or sixth month of pregnancy, they pass 
downward to the lower paid of the abdomen, and each testicle, 
from its lower part, sends forth a cord which is composed of 
cellular tissue and ligamentous fibres, and called the gubernacu- 
lum testis. Each cord passes through the inguinal canal, which 
is only two inches in length, proceeds obliquely downward, in- 
ward and forward, out of the lower part of the abdomen, and 
terminates in the bottom of the scrotum. In the eighth month of 
pregnancy, the testicles pass through the abdominal canals and 
reach the base of the scrotum, two or three weeks before birth. 
Occasionally, one or both are retained in the body until the fif- 
teenth or seventeenth year (although they seldom permanently 
* The abuse and consequent diseases of the generative organs of the female, have 
been fully considered in a preceding part of this volume. (See “ Masturbation a 
Fruitful Cause of Disease in Women.) STRUCTURE OF THE TESTICLE. 
789 
remain). This circumstance, however, does not always prevent 
procreation. 
1783. .Structure of the Testicle. Fig. 210 is an 
excellent illustration of the internal structure of the human tes- 
ticle, when its several parts are made distinct by being injected 
with mercury, and then so dissected as to be exposed to view. 
The numerals, 1, 2, 2, 
refer to a bundle of 
seminal tubes, each 
single hollow cylinder 
being about seventeen 
feet long and of an 
inch in diameter. As 
represented in the fig- 
ure, each small tube is 
remarkably convoluted, 
having the appearance 
of a miniature intestine 
and converges, as re- 
presented by the dot- 
ted lines, at 3; each 
bundle forms a single 
straight tube, which is 
called the vasum rec- 
tum. The vasa recta 
are twice the diameter 
of the seminiferous 
tubes, and are so wo- 
ven together as to form 
a complete net-work structure which is called rete testis, and sig- 
nifies a plexus of interlacing vessels. The body which is thus 
formed, and represented at 4, is an oblong eminence called the 
corpus Highmorianum. The tubes that compose this part, now 
unite to form the vasa efferentia (carrying vessels), which at 5, 
constitute little vascular cones, uniting to form a single tube, as 
seen at 6. This vessel remains single for a short distance, but 
soon becomes convoluted and has the appearance of an arched 
Fig. 210* 
A representation of the internal structure of a 
Testicle partially unravelled. 
* The thirty-two distinct representations given in the Colored Plates, when added 
to the preceding number of Wood Engravings, make this Pig. 210. 790 
COMMON SENSE MEDICAL ADVISEE. 
structure, in the back part of the testicle, termed the epididymis. 
The vas deferens — “ vessel bearing away,”—represented in that 
part of the engraving indicated by the numerals 7 and 8, is the 
excretory canal of the testicle. It arises from the epididymis, 
and as will be seen, at 8 becomes less twisted in its course, and 
at 9 is straight, and parallel to 10 and 11 —the spermatic artery 
and cord. The vas deferens is now a firm, white duct, about one- 
eighth of an inch in diameter, but its calibre is only the size of a 
fine bristle. The spermatic cord consists of spermatic arteries, 
veins, nerves and absorbents, besides its own proper coverings. 
1784. Sexual Desire. Man is prompted by a powerful 
instinctive desire for sexual gratification. The presence of 
semen in the seminal sac increases the nervous sensibility in the 
glans of the penis, which becomes erected and turgid with 
blood. The excitement is naturally increased by friction against 
the wrinkled walls of the vagina and at the acme of pleasurable 
enjoyment, by the action of the spinal cord, a reflex contraction 
is excited in the muscular fibres of the vasa ejferentia the ductus 
ejaculatorius and other parts which surround the genital organs, 
and the semen is thereby discharged with some degree of force. 
1785. Masturbation. This evil is also termed Solitary 
Indulgence, Self-Abuse, Onanism, Self-Pollution, Venereal De- 
bouchment, Voluntary Pollution, etc. The functions of the sexual 
organs are greatly impaired by this unnatural practice, which is 
the pleasurable excitation of the genital organs by friction with 
the hand. This act results in thrilling, though momentary en- 
joyment. 
1786. It is a deplorable fact that this vice is sometimes 
acquired by boys before they reach their sixth year. In some 
instances the habit may be attributed to foolish or vicious female 
servants, (particularly foreign nurses), who quiet children when 
they cry by tickling their sexual organs. These witless persons 
may not know how dangerous such a practice is to health and 
morals, or how easily the child is overcome by his propensities. 
It is wrong to commit these important trusts to the keeping of 
those who may easily transform a naturally healthy desire into a 
precocious morbid sensibility that will eventually ripen into a 
degrading animal lust. 
1787. What attentive observer of human nature has not MASTURBATION. 
791 
seen older boys act as though unaccountably influenced by some 
devilish inspiration which caused them to regard the practice of 
this vice, like the vile habit of smoking and chewing tobacco, as 
a manly accomplishment. It is evident that they act under the 
impression that the practice of self-pollution indicates their near 
approach to adult maturity, and thus vie with each other as to 
who shall first succeed in awakening his sexual sensibilities suf- 
ficiently to give unmistakable evidence of his masculine attri- 
butes. One boy may inherit a predisposition to this practice, or 
his sexual feelings may be awakened at an early age and his bad 
example be imitated by many others. In this way a dangerous 
custom is early acquired, and when the sexual propensities are 
habitually indulged to the exclusion of the cultivation of higher 
and nobler pleasures, he will very likely, when he becomes, a 
man, if not rendered impotent by these abuses, transmit the 
same desires to his offspring, so that the propensity and habit 
become irresistible—a physical as well as moral disease. 
1788. Solitary indulgence is a deplorable and prevalent evil 
among boys. Parents neglect to talk familiarly with their 
children upon this subject, and are very often incapable of 
giving proper advice. The child’s confidence must be gained 
through sympathy and tender personal concern. Diffidence and 
suspicion on the part of the parent destroys confidence in the 
child. Parents should divest themselves of all false delicacy, 
make common cause with the child, and by their frankness be 
able to establish an affinity of understanding which will result 
in mutual influence. The physician compassionately meets his 
patient, is pitiful, tender, kind, arid his heart is in the right place. 
When parents are similarly pervaded with sympathy, they can 
win the confidence, guard the health, and preserve the morals, 
of their children. 
1789. If the lad be instructed that this sexual enjoyment is a 
degrading pollution—a low practice, in which no right-minded 
boy will indulge—the gratification will instinctively be followed 
by a sense of disgust and self-condemnation. He may then be 
made to realize that restraint is far more manly and that self- 
control is a higher test of maturity than the humiliating, degrad- 
ing indulgence, termed venereal debauchment. Nature requires 
her own time to nourish the body, develop the child, complete 792 
COMMON SENSE MEDICAL ADVISER. 
the physical framework, and bring every part to the perfection 
of maturity. The muscular exertion required in sports and plays 
—the athletic exercises of youth—tends to develop the physical 
powers, which coincide with manly energy, restraint, self-reliance, 
heroic nobleness, and daring intrepidity. Let boys compete with 
each other as to who shall excel in true heroism. Let them emu- 
late each other in all that is worthy, fair and correct, in all that 
is just, lawful and right; such a strife will bring out the highest 
attributes — those croAvning excellencies of character which 
distinguish and honor Manhood. 
1790. The habit of solitary indulgence is called self-abuse, 
even when no semen is lost. Injury is done to the nervous sys- 
tem, since the practice is attended by an observable loss of ner- 
vous power. (See page 745.) The appetite for such indulgence 
increases, until the boy becomes, in later years, if not impotent, 
a victim to sexual intemperance. His love of sensual pleasure is 
early developed and grows upon him until he becomes a mono- 
maniac on this subject. While “ it is never too late to mend,” 
yet a perfect redemption from this habit, like that of drunken- 
ness, is difficult, and can be achieved only by a determined and 
persistent effort, which, many times, will require the aid of medi- 
cine to allay the unnatural sexual excitement. 
1791. The Indications of this Vice in Voting 
ISoys, are irritability, impatience and restlessness, they lose flesh, 
become pale, sunken-eyed, timid and downcast in look. There is 
loss of memory and the intellect becomes enfeebled. They are 
depressed in spirits, easily discouraged and prefer solitude. They 
do not retain what they learn, the general health fails, and the 
nervous system shows serious impairment. These symptoms are 
too significant to deceive the experienced eye, and oftentimes the 
short, irritable replies of the boy to his mother, and his general 
quickness of nervous sensibility, is indicative of the loss of 
nervous power occasioned by this habit. 
1792. Preventive Treatment. This evil can only 
be prevented by knowing and regulating the habits of children 
in early life. As soon as this practice is acquired, the child needs 
to be forewarned of its destructive tendency, and told that such a 
practice results in calamities that will embitter the whole life. 
Parents hesitate to talk to their boys, perhaps from fear of SPERMATORRHOEA. 
putting impure ideas into innocent minds. Their hopes are 
strong that their dear lads will never be guilty of indulging in so 
disgusting a practice. As I have before advised, far better is 
it that parents warn their darling sons against the syren vice. 
It is a false delicacy that restrains parents from fulfilling this 
duty. If it is not their business to attend to their children’s in- 
terests, who then will feel any right to allude to these important 
matters. 
1793. Let me then urge upon parents the necessity of fore- 
warning their children against yielding to this pernicious desire. 
Boys must know that they may be thrown into the company of 
older lads who, perhaps, have practiced masturbation and will 
solicit them to engage in the same vile habit. They must expect 
to meet with such influences and examples, and be able to with- 
stand the temptation and the persuasions of their associates. 
They must be taught to resist these propensities and exercise self- 
control, or they will be carried by the swift current of licentious- 
ness to utter moral and physical ruin. 
1794. If, however, the habit be formed, the child must be re- 
quired to rise early, take cold hand-baths and exercise, that the 
blood may be diverted into the muscles, for their growth and 
reparation. Let the thoughts be directed in proper channels, 
and the taste for manly sports be indulged. Let him be en- 
couraged in such amusements as croquet, ball play, quoits, walk- 
ing, hunting, rowing, playing at foot-ball, gymnastic exercises, 
etc. Or, let him become interested in the cultivation of flowers, 
gardening, raising of crops, in the care of animals in which he 
acquires a pecuniary interest, and in these healthful ways the 
mind will be diverted from sexual objects. If these hygienic 
means be not sufficient to overcome the morbid sexual excite- 
ment caused by solitary indulgence, then a physician of large 
experience and skill should be consulted, that the proper reme- 
dies may be applied in time to save the child from becoming in 
later life a victim of spermatorrhoea and impotency. 
1795. Spermatorrhoea {Seminal Weakness), or emis- 
sion of sperm without copulation, is generally induced by the 
early habit of masturbation. It is one of the evidences proving 
that passion, instead of prudence has held sway. The ancients 
believed that the gods were witnesses of secret crimes, and that 794 
COMMON SENSE MEDICAL ADVISER. 
they bore testimony notwithstanding all attempts at concealment! 
Passion may aptly be termed the voice of the body, by which, 
if we listen, we are enchanted and led astray. Conscience is the 
voice of the soul, which remonstrates, and, if we obey, we shall 
be guided aright. We cannot stifle these conflicting voices, and 
if we indulge in passion when conscience forbids gratification, 
the remembrance of the wrong remains forever, and constant 
fear is an everlasting punishment. Certain it is that dissipation 
and youthful indiscretion will result unfortunately, or there is 
no warning in the quaint lines of the Irish poet, Mangan: 
“ Guard your fire in youth, O Friends, 
For manhood’s is but phosphorus; 
And small luck or grace attends 
Gay boaters down the Bosphorus.” 
1796. Man possesses few powers which are more highly prized 
than those of sexual virility, which is the very essence of man- 
hood, the essential quality of masculinity. “ He is but the 
counterfeit of a man, who hath not the life of a man.” The 
sperm is, without dispute, the most important and the most 
precious secretion of the animal economy. It is the purest 
extract of blood; and, according to the energetic expression of 
Fernel, “ totus homo semen estP 
The semen, which we have said is secreted by the testes, is a 
milky fluid of mucous consistence, and when perfectly elaborated, 
contains no albumen in its composition. It is intermixed wfith 
the fluids secreted by the vesiculae seminales, prostate and Cow- 
per’s glands. Its fertilizing property depends upon the presence 
of minute bodies termed spermatozoa. (See Fig. 1, page 11). 
1797. The Seminal Fluid consists of the purest and 
most vital elements in the human body. It not only contributes 
to maintain the life of the individual, but it communicates the 
essential, transforming principle which quickens into being a 
mortal having an imperishable existence. Hence the sperm con- 
tains the very quintessence of life, the highest, most etherially 
pure and delicately refined elements of being. Its waste, there- 
fore, is a wanton expenditure, which robs the blood of its richness 
and exhausts the body of its animating powers. No wonder 
that its loss enfeebles the constitution, and results in impotency, 
premature decay, skin diseases, St. Vitus’s dance, paralysis, NOCTURNAL EMISSION'S. 
795 
epilepsy, consumption, softening of the brain and insanity. No 
wonder that conscience and fear become tormenting inquisitors, 
and that the symptoms are turned into imaginary spectres of 
stealthily approaching diseases. 
“ There is no future pang 
Can deal that justice on the self-condemned 
He deals on his own soul.” 
1798. Sperm represents the forces of life, and may be com- 
pared to a spring exhibiting vital tension. The watch runs with 
regularity by means of the tension of its elastic spring. If that 
power be weakened, the friction and resistance of the wheels 
cause the watch to stop. So it is with man. Expend the semen 
and the vital force is exhausted, for all of the functions are obe- 
dient to its energy. There is nothing left to propel the delicate 
machinery of the functions, which, from sheer exhaustion, come 
to rest. “ Whatsoever a man soweth, that shall he also reap.” 
The practice of onanism squanders the equivalents of vitality and 
bankrupts the constitution. Indigestion, innutrition, emaciation, 
shortness of breath, palpitation of the heart, nervous debility, are 
all symptoms of this exhaustion. Subsequently the yellow skin re- 
veals the bones, the sunken eyes are surrounded by a leaden 
circle, the vivacious imagination becomes dull, the active mind 
grows insipid, in short, every function wanes in consequence of 
the vital force, or spring, losing its tension. The great folly of 
excessive lustful enjoyment leads to feebleness, and finally ter- 
minates in disease and impotency. 
1799. Seminal weakness may be the result of marital excesses. 
A proper sexual gratification contributes to the health and hap- 
piness of both parties. On the other hand, intemperate indul- 
gences— permitted by the marriage relation—not only prevent 
fruitfulness, but ultimately render the husband entirely impotent, 
and undermine and destroy the constitution of the wife. Sperm- 
atorrhoea may be induced by spinal irritation, intestinal worms or 
piles. It may also result from inherited, as well as acquired, 
constitutional weakness. 
1800. Nocturnal Emissions. Involuntary emissions 
of semen most frequently occur during erotic dreams at night, 
and are therefore termed nocturnal emissions. Although they 
are at first occasioned by lascivious dreams, attended by erections 796 
COMMON SENSE MEDICAL ADVISER. 
and pleasurable sensations, yet, as the disease progresses, the 
erections become less perfect and the losses are only revealed by 
the depression of spirits experienced the following morning, and 
by the stiffened and stained spots upon the linen. These emis- 
sions may at first occur but once in two or three weeks, unless 
the patient be excited by company, stimulating food, drinks, or by 
other causes; but at a latter stage of the disease they sometimes 
take place every night. In aggravated cases, the seminal sacs are 
so weakened that the warmth of the bed, friction of the clothing, 
reading obscene literature, viewing indecent pictures, indulging 
in lewd conversation, or even being in the presence of women, 
produces a waste of semen — many times unattended by erec- 
tions. When there is great weakness, seminal discharges may be 
induced by lifting heavy weights, pressure upon the genital 
organs, from horseback riding, straining at stool, or even upon 
urinating — as observed when muscular efforts are made to ex- 
pel the last drops, which appear thick and viscous. If the urine 
be allowed to stand for a few hours, the seminal discharge will 
Fig. 211. 
Fig. 212. 
The Testicle in a healthy condition, 
precipitate and form a light-colored deposit at the bottom of 
the vessel. If the sediment be examined with the microscope, 
spermatozoa can readily be detected in it. Spermatorrhoea not 
only occasions loss of semen, but frequently the testicles waste 
A Testicle wasted by Masturbation, NOCTURNAL EMISSIONS. 
797 
away until they become nearly destroyed. Fig. 211 is a good re- 
presentation of one of these glands in a healthy condition, while 
Fig. 212 represents one nearly absorbed, as the result of self-abuse. 
It is an illustration of genuine testicular consumption, or progress- 
ive emaciation, and shows the tendencies of venereal excess, 
to waste away the system. 
1801. When the testicle is simply congested, there is little or 
no pain; but when it becomes tender and sensitive, inflammation 
is indicated. If the inflammation be violent, the tongue becomes 
furred, the pulse quick and hard, the skin hot, and the bowels 
constipated; if it proceed to suppuration, the symptoms are 
aggravated, and chilliness of the surface is experienced. Much 
time elapses before an abscess bursts, but when this happens, 
several openings are formed which discharge pus and seminal 
fluid, and are difficult to heal. 
1802. Hydrocele (Dropsy of the Scrotum) consists of an undue 
secretion of the fluid which moistens the tunica vctyincdis, and 
may arise in consequence of irritation of the testicle 791). 
1803. Varicocele is a dilatation of the veins of the spermatic 
cord and scrotum, and is frequently a result of masturbation. 
It is readily distinguished under the form of a soft, doughy, 
compressible, knotty and unequal enlargement of the veins, and 
a tumid condition of the adjacent parts. One writer, speaking 
of the enlargement of the spermatic vessicles, describes them as 
“ feeling like a coiled-up bundle of worms.” This disease may 
be the cause of impotency. 
1804. Disease of the Prostate Gland is frequently caused by 
solitary indulgence. Venereal excess will produce congestion 
and prostatic enlargement. The gland becomes overnourished 
and its unusual increase in size is called hypertrophy. For a 
full consideration of this affection see 1756. 
1805. The habit of self-pollution weakens all the structures 
of the genital organs, and induces seminal waste, which may- 
lead to a morbid diminution in the size of the prostate gland. 
This condition, which is exactly the opposite of the one above de- 
scribed, is atrophy. Any structural disease that interferes with 
nutrition or renders the circulation in the prostate gland 
languid and feeble, will pi-omote impairment of that organ. Any 
practice that drains the blood of its richness, tends to develop 798 
COMMON SENSE MEDICAL ADVISER. 
scrofula, ulceration and abscess, in short, weakens and destroys 
the structure of the organ thus implicated, and the habit, to 
which we allude does impoverish the blood and produce disease 
in the structures of the prostate gland. 
1806. Impoteiicy (Zoss of /Sexual Power). Masturba- 
tion perverts the excitability of the nervous system and sexual 
organs and causes debility which is indicated by the premature 
discharge of semen during sexual intercourse. These premature 
emissions indicate not only partial impotency, but also that the 
nervous centres are impaired and have become morbidly sensi- 
tive by the practice of solitary vice or marital excesses. At 
length the powers of the erectile tissues are diminished and 
there is weakness at the root of the penis when erect, thus pre- 
venting the act of copulation, or the erection may be slow and 
not last long enough, on account of a faulty functional condi- 
tion of the spinal cord. This condition is sometimes associated 
with a morbid irritability of the urethra, which, being inflamed, 
may become sufficiently constricted to prevent the emission of 
semen when the penis is erected. Or inflammation may extend 
downward to the vesiculce seminales, and cause a discharge of 
thick, ropy, viscous slime. The reader will observe in Fig. 107, 
that the seminal sac is deep seated; and when the inflammation 
in the urethra proper, has subsided, it may be continued to the 
seminal sac and give rise to a discharge of mucus, although 
unattended by pain. The remedies which are available in acute 
gonorrhoea are not useful in chronic inflammation of the vesi- 
culce seminales. This prolonged discharge is often erroneously 
regarded as gleet, and so long as it is treated by injections, 
copaiba, capsules and other similar mixtures, it will resist all 
efforts made for its removal, much to the annoyance of the 
patient. 
1807. The habit of masturbating perverts and finally destroys 
the secretory functions of the testes. It sometimes causes chronic 
inflammation, which may result in obliteration of the minute 
seminal canals, or obstruct the conveying ducts. It enervates 
and invalidates the secretion of semen, and the sperm is imper- 
fectly elaborated and totally unfit for procreative purposes. The 
vital products (spermatozoa) become unhealthy, morbid and de- 
formed. Sometimes they are entirely absent from the sperm; or SYMPTOMS OF SPERMATORRHOEA. 
799 
when present, they are very few in number, incomplete in struc- 
ture, diseased and deficient in power as well as in organization. 
Fig. 213 represents these spermatozoa in a healthy condition, and 
Fig. 218. 
Fig. 21Jf. 
Microscopic appearance of 
healthy semen. 
Microscopic appearance of semen 
which will not fecundate. 
Fig. 214 when they are sickly, deficient and inanimate. The 
husband may appear to be healthy, and his inability to procreate 
may wrongfully be considered as a defect in his wife. 
1808. Symptoms of Spermatorrhoea. The indi- 
cations of abuse of the sexual organs are loss of nervous energy, 
dullness of the mental faculties and delight in obscene stories; 
the expression becomes coarse, and the movements slow; the eye 
is sunken, the face bloated and pale, and the disposition is fretful 
and irritable; the appetite becomes capricious, sometimes it is 
voracious and at others it is entirely wanting; the throat is irri- 
tated, and the patient makes frequent attempts to clear it, in 
order tor speak distinctly; there are pains in the chest,wakefulness, 
and during the night lascivious thoughts and desires; the relish 
for play or labor is gone, and there is a growing distaste for 
business; there is a determination of blood to the head, headache, 
noises and roaring sounds in the ears, the pupil of the eye is 
dilated, the white is blood-shot, there is partial blindness, the 
eye becomes watery and the patient imagines bright spots or 
flashes passing before it; there is increasing stolidity of expres- 
sion, the eye is without sparkle, and the face becomes blotched 
and mox-e animal-like in its expression; there is carelessness in the 
personal appearance, and a lawlessness with regard to scrupulous 
neatness; not unfrequently a rank odor exhales from the body, 800 
COMMON SENSE MEDICAL ADVISEE. 
and the person complains of troublesome itching and crawling 
sensations in and about the scrotum. 
1809. Subsequently, symptoms of indigestion appeal-, ob- 
stinate constipation and all the complaints of a dyspeptic 
follow. Little by little the pallor heightens, the patient grows 
thin and the signs of debility increase. There is shortness of 
breath, palpitation even from moderate exercise, trembling of the 
knees and ei-uptions on the surface. Or there may be cough, 
hoarseness, stitch in the side and loss of voice. The sleep is not 
refi-eshing, the dreams are lascivious, and the involuntary emis- 
sions of semen become more frequent. The weakness increas- 
ing, the sufferer expei-iences feebleness in his legs and staggers 
like a drunken man, his hands ti-emble and he commences to 
stammer. 
1810. The patient is unable to concentrate his thoughts, can- 
not remember what he reads, and is mentally indolent. He 
begins to be more suspicious of those about him, has less confi- 
dence in others and desires to be alone, is despondent and has 
suicidal thoughts. Semen is prematurely discharged upon at- 
tempting coition, and if there be offspring it is apt to be feeble 
or subject to scrofula, consumption or convulsions. He has pain 
in the back, does not like to walk, and is inclined to lie down. 
The genital organs diminish in size, lose their energy, there is 
itching and tickling in the glans of the penis, which becomes 
cold, flaccid and tender. There is a frequent desire to urinate, 
chronic irritation in the neck of the bladder, and pain running down 
the cord to the testicle. The microscope shows that semen invol- 
untarily discharged may be devoid of spermatozoa, or if present, 
they are defective, the filaments having no head or an imperfect 
one, and being without a tail. The urine is loaded with mucus or 
bears up a filmy, membranous, transparent substance, something 
as the atmosphere sustains a translucent cloud. At other times, 
the urine is covered with an oily looking substance, which thinly 
gilds the surface. Or it may contain sediment in solution, which 
deposits in crystals or incrusts the urine, and again it may pre- 
cipitate a brick-dust looking material, and sometimes bloody 
semen; the patient grows pale and thin, the digestion is slow, and 
flatulence and acidity of the stomach are followed by diarrhoea. 
There is cramping and rigidity of the limbs, the feet bloat, SYMPTOMS OP SPERMATORRHOEA. 
801 
melancholy seizes upon the mind, the patient feels forsaken and 
loses nearly all hope of recovery. 
1811. As the disease progresses there is a want of firmness 
and decision, absentmindedness and difficulty in moving about. 
When the erections are imperfect and the semen is prematurely 
discharged, or when a lengthy coition is required before the 
sperm can be ejected, it is evident that the patient is rapidly be- 
coming impotent; the virile powers are vanishing and manhood 
is surrendering its sway to a merciless foe. How frequently do 
I witness this condition in men, even at the age of thirty-five, 
when the summit of vigor and strength of manhood should only 
have been reached. How often am I solicited to restore these lost 
hopes and powers. To what tales of ignorance and recklessness, 
or submission and remorse do I repeatedly listen from these 
unfortunate sufferers. Those who labor under these conditions 
rarely have spontaneous emissions. Sexual intercourse prevents 
what would otherwise be involuntarily emitted, but it does not 
remove the functional and organic lesions of the nerve-centres. 
Hence, at a time when the victims of this disease should be in 
the prime of life, they are rendered wholly impotent, and epi- 
lepsy, softening of the brain, apoplexy, paralysis, or insanity 
frequently results. 
1812. A peculiar form of impotency is associated with cer- 
tain abnormal nutritive changes, which give rise to lymphatic 
conditions. Not that the tempex*ament in all these cases is 
originally lymphatic, but the system degenerates in consequence 
of nutritive perversion. With the loss of sexual ardor, there is 
also apathy of mind, loss of manliness, and the victim becomes 
cold, dispassionate and treacherous, devoid of any admiration or 
love for the opposite sex. He acquires rotundity of person, the 
face is fat, smooth, often beardless, and the voice is feminine. 
1813. There are two distinct characters represented in this 
class, viz: (1,) those that are fearfully tormented by a knowledge 
of the fact that they are losing their virile powers, and become 
irritable, jealous and often desperate; and (2,) those who are 
completely indifferent to this deprivation. In both instances, 
impotency is the result of either self-abuse or sexual excess. 
(1.) Cases of the former character are readily restored to 
health by proper treatment, for they are willing to make an 802 
COMMON SENSE MEDICAL ADVISEE. 
exertion for the recovery of their manly powers. There is not 
complete loss of sexual desire, yet their disappointment is so 
great that they may entertain suicidal thoughts. They are 
moody, fickle in their purposes, discontented, excitable and re- 
markably impulsive. With proper treatment, they regain tone 
of body, vigor of mind, an increase of sexual desire, and become 
more attentive to business affairs, and less indifferent to the 
gentler sex. With the restoration of the general health and of 
the sexual functions, remarkable constitutional changes occur. 
It is often the case that their intimate friends hardly recognize 
them by looks or acts. 
(2.) It is equally true that those who are wholly indifferent to 
the loss of virile powers, uninterested in the evidences of their 
want of manhood, are sometimes incurable. In fact it is of little 
use to treat the latter class, because they will neither co-operate 
with the physician, nor persist in the treatment necessary to 
effect a radical temperamental change. 
Although I have minutely described the symptoms which are 
common to the different stages of spermatorrhoea, partial and 
complete impotency, yet no one suffering from these diseases 
will, at any stage, experience more than a small part of those 
enumerated. 
1814. Moral Considerations. Masturbation is a 
liabit that tyrannizes over the mind, perverts the imagination and 
forces upon the victim venereal desires, even while he is forming 
the strongest resolutions to reform. It despotically constrains 
into its service the higher qualities, such as friendship, confidence 
and love, the ingenuity of reason, the refining faculties of ideal- 
ity, purity, and the shadowy illusions of spirituality, to make its 
ideal graceful and beautiful. Thus it is that the fancy creates 
an attractive partner, possessed of girlish beauty—a perfect 
type of goodness, blended with sexuality, and whom he worships 
with all the ardor of passion. Around this beau ideal all the 
affections are clustered; to her the purest of his blood is offered 
in sacrifice, and it is no wonder that female associates seem tame 
and unattractive when such an imaginary and consummate 
divinity is courted. Thus we see how this habit makes the 
spiritual faculties subservient to morbid passion, and by what 
means the charming, enchanting and delectable influences are MORAL CONSIDERATIONS. 
803 
prostituted to vulgar and base-born creations. In the sensual 
delirium, is conceived an elysium of carnal bliss, where half-nude 
nymphs display their charms and invite to sensual enjoyments. 
1815. Montaigne says: “We must see and get acquainted 
with our sins if we expect to correct them.” Virtue presup- 
poses trials just as much as victory implies warfare. The 
triumph of virtue is to defeat morbid or excessive passion, for 
virtue is only realized when it is a conquering force. Innocence 
may be passive, but virtue is an active, volitive quality, purified 
in the fiery furnace of temptation. As men in all ages have 
been influenced by the same passions, so now as ever, temptation 
will find its victims. It is an obligation that one owes him- 
self to overcome every evil passion or weakness to which he is 
subject, and the discharge of this personal duty will require 
great moral courage. 
1816. Our Saviour invited all erring mortals to enter upon a 
higher life when lie said, “ Come unto me, all ye that labor and 
are heavy laden, and I will give you rest.” The invitation is 
accompanied with a promise. To all who are weary of excess 
and bowed down by passion, this rest and restoration $re 
promised. To all who suffer grievous injury from the gratifica- 
tion of lust we say, come and be healed. 
1817. We can only in part delineate the terrible effects re- 
sulting from the abuse of the sexual organs. The symptoms are 
multitudinous, but we do not pretend that they all appear in any 
one patient. No one could endure them all. No two persons 
act alike, nor are they similarly influenced by disease. The 
symptoms will vary according to the severity of the affection, 
the age of the patient, and his constitutional peculiarities. The 
presence of several of the symptoms which we have enumerated, 
is evidence of abnormal weakness, demanding treatment. Immod- 
erate sexual indulgence causes an impairment of the nervous 
system, and thus weakens the whole organization. Not only the 
corporeal powers, but the morale of a man, depends upon his 
keeping within prudent limitations. 
1818. The animal propensities are good servants, but galling, 
cruel masters. It has been said, that they do and undo every 
thing. There is a saying, that pilots fear, beyond every thing, 
those halcyon seas where the vessel obeys not the helm, and that 804 
COMMON SENSE MEDICAL ADVISER. 
they prefer wind at the risk of shipwreck. So the passions in 
men are the motive powers of being, though they often wreck 
the constitution. “Moderation is like Temperance; we would 
wish to eat more, but are afraid of injuring our health.” 
1819. Just as there is no rest without coming to the Saviour, 
so there can be no restoration to health without due observance 
of physical laws—abandoning the habit of self-abuse. There can 
be no salvation unless sin be discarded, and so there can be no 
redemption from the bad effects of a practice, so long as it is 
continued. It is no easy task to master a domineering passion. 
It will prove obstinate and capricious if humored. The strength 
of appetite and of animal propensity is often greater than the 
force of the will. The treatment begins by moral reformation. 
Every manly impulse and all the higher qualities of the patient’s 
nature should be enlisted in the struggle for virtue and health. 
If the passions be restrained, then the capital of health in- 
creases, for the saving of the vital secretions is equal to com- 
pound interest. It illustrates the truth of the Latin proverb: 
“No gain is so certain as that which proceeds from the econom- 
ical use of what you have” ! For the patient actually acquires 
confidence and manly courage by the retention of the seminal 
fluid which directly increases his virile forces. 
1820. Hygienic Advice to Patients. It is im- 
portant that the mind as well as the physical powers he directed 
into active and wholesome channels. Daily physical exercise 
and regular habits must be established. This general direction 
includes many essential particulars. There must be restraint 
and discipline of the mind. It is useless to begin medical treat- 
ment while the patient continues to read exciting, amorous 
stories—novels describing the weaknesses of lovers—obscene 
books, which are very suggestive of lewd thoughts. Something 
practical ought to occupy the thoughts and engage the hands. 
Regular and vigorous physical exercise is necessary to assist 
the circulation of the blood and compel its movement in the 
minute and extreme parts of the vascular system. When the 
blood is thus directed, nutrition is more vigorous and the ac- 
tivity of all the functional forces is augmented. 
1821. Not only should there be regularity in eating, but sound 
discretion should be exercised in selecting a plain, wholesome HYGIENIC ADVICE TO PATIENTS. 
805 
diet, consisting of such articles of food as favor a daily and 
free evacuation of the bowels. (See article on Constipation.) 
Avoid the use of those articles of food which produce excessive 
acidity of the stomach. Hearty or late suppers are not allowable. 
The patient should use no alcoholic beverages and abstain from 
such stimulants as tea, coffee, beer, wine or tobacco. I cannot 
even recommend their moderate use, for total abstinence is the 
better plan. If a speedy cure is desired, use no beverage but 
cold water. 
1822. The patient should sleep in a well-ventilated room, on 
a hard bed, and be covered barely sufficient for warmth and 
comfort. He should not lie upon the back, because in this posi- 
tion nightly emissions are more likely to occur. The patient 
should go to bed when he feels sleepy, and not resist the inclina- 
tion until wakefulness is induced. 
1823. He should rise early in the morning and immediately 
take a cold hand-bath. For this purpose a quart or two of 
water and a common towel only are required. After bathing 
rub the surface of the body with the dry hand or a crash towel, 
and continue the friction until the skin is red and full reaction 
established. Do not excuse yourself from following these 
hygienic suggestions. A refreshing bath changes the morbid 
sensibilities to more healthful states by the reaction produced in 
the nervous system. 
1824. Sometimes it is beneficial to apply a towel saturated 
wfith cold water to the genital organs fifteen minutes before 
leaving the bed. Douching or showering the genital organs 
with cold water once or twice a day will also be beneficial. It 
should not be practiced, however, just before going to bed. It 
is well to bathe the head in cold water, and this direction can be 
followed much better if the hair be kept closely cut. 
1825. Horseback riding, climbing, and all exercises that rub, 
chafe, or excite the genital organs should be avoided. Even the 
clothing should be loose, so that walking will not produce fric- 
tion or cause any excitement of these organs. The calls of nature 
should be promptly attended to, and the urine voided at any 
time, (especially during the night season), when there is an incli- 
nation. If there be irritation of the bladder and lower bowels 
the patient will receive decided benefit from the daily use of an 806 
COMMON SENSE MEDICAL ADVISER. 
injection of cold water into the bowels. From a half pint to a 
pint of cold water may be used at one time, and the injection 
should be retained for a few minutes before going to bed. The 
bowels will thus be relieved, the heat and irritation subdued and 
the liability to seminal emissions lessened. 
1826. Patients should not allow their thoughts to dwell upon 
their ailments, for they are apt to become moody, self-deceived 
and even insane upon this subject. They become suspicious, 
skeptical and believe that they are victims of imposture. When 
they lose self-reliance, their faith and trust in others begins to 
waver, especially if their health does not improve as rapidly as 
they had anticipated. As much depends upon the faithful ob- 
servance of the physician’s hygienic advice as upon the constant 
and loyal use of medicines. The rapidity of recovery depends 
upon the constitutional energies and the vigor of the vital re- 
sources. If the blood be greatly impoverished, or the nervous 
system much impaired, recovery will necessarily be slow. Time 
and trial, patience and perseverance are just as essential elements 
to a recovery from the effects of these abuses as the best medi- 
cal treatment which can be employed. 
1827. The Medical Treatment of Sperma- 
torrhoea aild Impotcncy. As indicated in the intro- 
duction to Part IV of this volume, 676, (3), I have omitted to 
advise any special course of medical treatment for those obscure 
and complicated chronic diseases, the successful management of 
which demands the greatest professional skill. Concerning the 
medical treatment of spermatorrhoea and impotency, I shall 
adhere to the same policy, believing that in this manner the best 
interests of the patient will be subserved. No other class of 
diseases requires so many modifications of treatment, to suit the 
peculiarities of individual cases, because no other is attended by 
so many complications and morbid functional and structural 
changes. Every complication must be considered, and great 
judgment exercised in the selection of remedies. As this selec- 
tion must depend upon the peculiarities of the case involved, it 
is impossible to impart to the non-professional, for whom this 
volume is designed, sufficient medical knowledge to enable them 
to choose the appropriate remedies for these intricate disorders. 
Hence it would be useless to disclose the various medicines which MEDICAL TREATMENT OP SPERMATORRHOEA, &C. 
807 
I employ in treating them. It would only lead to popular em- 
piricism—to the making of many fruitless experiments, which 
would many times result in great harm to the afflicted. 
1828. The invalid should restrict his attention to hygiene, 
and learn that patient endurance and heroic perseverance are 
necessary, even when taking the most efficient medicines. His 
entire system has gradually become deranged, and corrective 
medicines must be chronic in their operations; in other words, 
they must act insensibly, slowly and progressively. And yet, as 
if to encourage the patient, some of the symptoms of sexual 
weakness will, under proper hygienic and medical treatment, 
generally begin to disappear within a month. When, however, 
the nervous system is very much impaired, a longer time will 
elapse before the corrective and restorative effects of treatment 
will be observed. The physician should neither advise, nor the 
patient expect, that a broken-down constitution can be immedi- 
ately repaired. The day of miracles is passed. The most rational 
method of treating the sick promises nothing supernatural—• 
nothing which is not in accordance with science. 
1829. Years ago, I resolved to pay particular attention to the 
investigation and treatment of this class of diseases, which are 
not only alarmingly prevalent, hut sadly neglected and mis- 
treated by the general practitioner of medicine. Accordingly I 
have tested and developed a series of vegetable remedies, which 
not only arrest all forms of seminal discharges, but restore the 
wasted organs and their lost energy. Having successfully treated 
over twenty thousand cases, I can safely say of my remedies 
that they are rejuvenating elixirs and unfailing in their remedial 
effects. I now prescribe them, not only with assurance, but with 
the same confidence that I would give bread and beef to a starv- 
ing man to satisfy his hunger. The uniform success which has at- 
tended the employment of these remedies has led me to rely upon 
them with explicit faith. They render spermatorrhoea, or sem- 
inal weakness, and by their persistent use, partial, and even com- 
plete impotency, as curable as other chronic or lingering diseases. 
For these reasons I have particularly solicited those cases which 
have heretofore been regarded as incurable. The patient is 
subjected to no surgical operation, and he can safely and accu- 
rately follow the directions given, while the treatment does not 808 
COMMON SENSE MEDICAL ADVISER. 
interfere with any ordinary occupation in which he may be en- 
gaged. These delicate diseases should not be entrusted to 
physicians who advertise under fictitious names, or to those of 
ordinary qualifications. The general practitioner may be thor- 
oughly read in these diseases, but he cannot acquire the skill of 
a specialist who annually treats thousands of cases, while the 
former seldom, if ever, has occasion to prescribe for them. 
1830. Occasionally I receive letters soliciting me to under- 
take the cure of these ailments and in case of failure, receive 
no compensation. They write: “If you will •warrant that your 
prescriptions will result in a perfect restoration to health, we 
will gladly pay the fees that you ask.” The absurdity of such a 
request is apparent, and therefore, I answer: “I cannot warrant 
that you will live even for the next twenty-four hours. I do not 
bet, play for stakes, nor wager my skill for money. Personal 
responsibility cannot be shifted nor evaded, and life and health 
with all their momentous considerations are necessarily indi- 
vidual affairs. Therefore, a proposal to make the conditions of 
health a subject of speculation is a challenge to gamble.” The 
patient may not comply with the specified conditions, and the 
physician’s success depends upon a faithful application of the 
prescribed treatment. For these reasons only a quack will be a 
party to any such transaction. Ours is not a trading, hazard- 
ously speculative profession. The physician should not take 
advantage of the fears of his patients, but serve them with the 
best of his skill and in return receive a suitable remuneration. 
1831. Evidences of the Curability of Sper- 
matorrhoea and Impotency. Many individuals 
afflicted witli spermatorrhoea and impotency (particularly those 
who have been swindled by some of the many unprincipled char- 
latans who are to be found in nearly every city) are incredulous, 
and doubt my ability to cure these maladies. Others are skep- 
tical on this subject, because their physician, who may be a very 
good man and a very skillful general practitioner, having very 
little or no experience in treating these delicate maladies, has 
failed to give them relief, and, perhaps, tells them the disease is 
incurable. 
The author, therefore, begs the indulgence of his readers for 
here offering some indisputable evidences of the extraordinary EVIDENCES OF CUE ABILITY. 
809 
success which he has achieved by his peculiar methods of treating 
these affections. 
These evidences are introduced for the encouragement of an 
unfortunate class of invalids, with many of whom existence has 
ceased to possess any charms. No false modesty deters me 
from declaring that the grateful manifestations which I have 
received from this class of sufferers have afforded me one of the 
greatest pleasures of my life, and have alone been a rich remu- 
neration for the diligent study and arduous labors devoted to the 
investigation of these diseases and the perfection of my peculiar 
methods of treating them. 
1832. In introducing the following extracts from my ex- 
tensive files of letters, the names of the writers will be omitted, 
as I regard all such correspondence, as well as facts communi- 
cated to me in personal consultations, as sacredly confidential. 
However, to compensate for the omission of signatures, I shall 
prefix my affidavit of their genuineness. 
Lack of space and fear of wearying the reader, prevents me 
from introducing more than a few extracts; but these are only 
fair samples of thousands that have been received. Those given 
present cases in almost every stage of treatment, some soon 
after commencing, others farther advanced and still others after 
being cured. If I had the space and time to select them, I could 
insert an almost unlimited number of those received from 
patients who have been perfectly cured, but I think the reader 
will be more interested in expressions coming from patients in all 
stages of treatment, as they are received by me from day to 
day. Therefore, without regard for literary excellence, a mis- 
cellaneous lot will be given, verbatim. They express the senti- 
ments of persons in the ordinary, as well as the higher, stations 
of life, and illustrate the views and feelings generally entertained 
by those I have been called upon to treat. 
1833. The following extracts are the spontaneous acknowl- 
edgments of grateful patients and are more valuable and truth- 
ful than if obtained by solicitation—a practice contrary to my 
sense of propriety and hence never indulged in. Although 
ofttimes less expressive of satisfaction and gratitude than if the 
communication were presented in full, yet only sufficient space 
can be spared for a brief quotation from each letter. 810 
COMMON SENSE MEDICAL ADVISER. 
TIIE AUTHOR’S AFFIDAVIT. 
State of New York, 
County of Erie. 
ss. 
R. Y. Pierce, of the City of Buffalo, 
State and County aforesaid, being duly and solemnly sworn, says: That 
the extracts of letters hereunto appended, and from which the signatures 
are omitted, are genuine quotations from letters received by him, and 
that the said letters are now on file in his office; and furthermore, that 
the said testimonials w ere written without his (the deponent’s) invitation 
or solicitation, and are but fair samples of numerous others on file in his 
office, and of those daily received from all parts of the country. 
R. Y. PIERCE. 
Sworn before me, this 16th day of March, A. D. 1875. 
Wm. H. Jenkins, 
[COPY.] Notary Public in and for Erie County, N. Y. 
WORDS FROM OUR PATIENTS. 
Case I. Spermatorrhoea in a most aggravated form. A gentleman 
writing from Clark County, Ohio, says: “Although it required some 
longer time than I expected, nevertheless I am thankful that I am feel- 
ing so well at present. But a short time ago, my case was (to me) hope- 
less. That last medicine worked like a charm, so much so, that I don’t 
see any necessity for me continuing the treatment any longer.” 
Case II. A gentleman in Saline County, Missouri, writes: “I have 
taken the last of the medicine you sent me for the cure of spermatorrhoea 
and feel satisfied that it has entirely cured me. I have had no emissions 
for over a month, and no longer have the desire to masturbate.” 
Case III. A gentleman residing in Delaware County, Pennsylvania, 
writes: “ I began taking your medicine on the first of last December, 
1874, and since then have had a second lot. * * * * I think, with 
the blessing of God, I can get along without any more. I feel perfectly 
well at present — not a pain, ache or anything else to tell of sickness. I 
am stouter by fourteen pounds than I was two months ago. I have no 
more emissions.” 
Case IV. A gentleman writes from Juniata County, Pennsylvania: 
“ I don’t think I have any necessity to order any more medicine. I don’t 
have any night emissions since I commenced to use the medicine of the 
second month’s trial. I feel to return my sincerest thanks to you for the 
good which you have done me, and the kind attention which you gave 
me. I hope you may live long, to do the needy sufferers good.” 
Case V. A gentleman under treatment for spermatorrhoea writes 
from Labette County, Kansas: “ I am happy to say that I feel a remark- 
able change in my entire system. Nocturnal emissions have almost en- 
tirely stopped, erotic dreams seldom troubling me. I have gained in WORDS FROM OUR PATIENTS. 
811 
flesh and healthy appearance, and feel stronger, healthier, and more 
independent—more a man every way than ever before.” 
Case VI. The following expressive sentence is extracted from a 
letter which I received from a gentleman residing in Woodford County, 
Illinois. He was terribly afflicted with spermatorrhoea, resulting in 
partial impotency, and was treated only five months by the Faculty of 
the World’s Dispensary: “ I am well, married and happy.'1' 
Case VII. Spermatorrhoea. A gentleman writing from Scott 
County, Virginia, says: “With great pleasure and thankfulness of heart, 
I inform you that your medicine has cured me, I think, sound and well. 
I tried other doctors, and they failed, and my case became very serious.” 
Case VIII. A gentleman residing in New York City writes: 
“My store of medicine is about three-fourths gone, and I think it ad- 
visable to send for more. It is working splendidly. I have not had one 
emission this month, and I feel twenty per cent, better.” 
Case IX. Spermatorrhoea and Impotency. A gentleman residing 
on Staten Island, X. Y., writes: “I am happy to say that your medi- 
cine has perfectly cured me. I am well and strong.” 
Case X. Bad case of Spermatorrhoea. A gentleman writes from 
Hillsdale County, Michigan: “Your remedies have improved my health 
so much that my friends wonder what I am doing for myself.” 
Case XI. Bad case of Spermatorrhoea with partial Impotency. A 
gentleman writes from Lorain County, Ohio: “ I feel better than ever 
I did in my life. Back is not so weak, and I think I am cured.” 
Case XII. Case of partial Impotency resulting from Masturbation. 
A gentleman residing in Republic County, Kansas, writes: “I improved 
rapidly from the time I commenced taking your medicines. I consider 
myself well. On I married the lady whom I have long loved. We 
are happy, of course. I am a thousand times obliged to you for what 
you have done, and have confidence in your ability to cure whatever 
you undertake.” 
Case XIII. Bad case of Spermatorrhoea. A gentleman residing in 
Mercer County, Pennsylvania, writes: “The last lot of medicines sent 
by you was duly received and taken according to directions. When 
done I found myself well, hut deferred writing you until I should ob- 
serve whether the cure was permanent or not. I am getting strong and 
robust, and think myself cured, thanks to your skill.” 
Case XIV. Case of Impotency. A gentleman writes from Caledonia 
County,Vermont: “My health is very much improved in every respect. 
Have not been so well for ten years. I think my vital powers are fully 
restored. Have worked every day since I commenced taking the medi- 
cine.” 
Case XV. Case of Spermatorrhoea. A gentleman residing in 
Miami County, Ohio, who has been under treatment only one month, 
writes: “ I have taken your medicine, as directed, and feel like a new 
man. I have no desire to masturbate.” 812 
COMMON SENSE MEDICAL ADVISEE. 
Case XVI. A very had case of Spermatorrhoea. A gentleman 
residing in Brooklyn, New York, who has been under treatment five 
months for spermatorrhoea in its worst form, writes: “I have not had 
any loss of semen since the last time I mentioned in my foregoing 
report.” 
Case XVII. Spermatorrhoea. A gentleman who has had one 
month’s treatment, writes from Columbia County, Wisconsin: “I have 
had one emission since I began taking your medicine. I have a good 
appetite and sleep well, but to be sure of my cure, I will send to you for 
one more month’s treatment.” 
Case XVIII. A very had case of Spermatorrhoea with Impotency. 
A gentleman who had been under our treatment six months, and whose 
case was one of the worst we have ever treated, writes: “ I consider my- 
self cured. Have had no indications of the disease since your treatment.” 
Case XIX. A case of Spermatorrhoea of several years' standing. 
A gentleman residing in Kosciusko County, Indiana, after having been 
under treatment three months, writes: “It is with pleasure that I state 
to you that I am improving right along—gaining both in flesh and 
strength. The involuntary emissions, I think, have entirely ceased since 
I last wrote to you.” 
Case XX. A case of Spermatorrhoea. A gentleman writes from 
Napa County, California: “I don’t think I will need another month’s 
treatment, as even the first medicine nearly cured me.” 
Case XXI. A case of Spermatorrhoea. A gentleman residing in 
Cincinnati, writes: “I am getting along finely. I feel as well to-day 
as I ever felt.” 
Case XXII. Spermatorrhoea and Impotency. A gentleman, after 
having been treated by me for three months, writes from Essex County, 
Massachusetts: “ I have used medicines you .sent according to directions 
for the cure of spermatorrhoea, and feel satisfied they have had the de- 
sired effect. In short, I feel myself a man again.” 
Case XXIII. Spermatorrhoea. From Des Moines County, Iowa, 
come the cheering words: “I deem it my duty to acknowledge to you 
the valuable service which you have performed for me. The last medi- 
cine you sent me for the cure of seminal weakness, caused by youthful 
indiscretion, was sent over eight months ago. I now feel that I am 
cured of that disorder, and am very thankful to you.” 
Case XXIV. Spermatorrhoea. A young man residing in Dickin- 
son County, Kansas, writes: “I have to state that I am a great deal 
better, in fact I consider myself cured. The emissions have entirely 
stopped, and I have no desire to masturbate any more.” 
Case XXV. Spermatorrhoea and partial Impotency. A gentleman 
residing in Jennings County, Indiana, after taking my treatment for 
four months, writes: “Through your aid I am once more restored to 
perfect health. I no longer have the desire to masturbate. I feel like 
a new man in every respect.” WOBDS FROM OUR PATIENTS. 
813 
Case XXVI. Impotency,—the result of Spermatorrhoea. The fol- 
lowing is from a gentleman residing in Providence County, Rhode 
Island, who had long been a sufferer from impotency, and was perfectly 
restored, in six months time, by my peculiar mode of treating such 
cases: “It is with pleasure that I make the following report to you. I 
feel that the cure is complete and permanent. I cannot thank you 
enough for having been the means of saving my life, for I know that I 
could not have lived a great while had it not been for your treatment 
and advice. I was in a most pitiable condition when I applied to you. 
I can now associate with my fellow-men and feel that I am their equal. 
I thank God that you have been the means of restoring that health and 
strength to me, which I so foolishly and wantonly wasted.” 
1834. Did space permit and the interest of my readers de- 
mand it, I could add to the preceding list an almost endless 
number of extracts from letters written by grateful patients ex- 
pressing their heart-felt thanks for having been cured of sperm- 
atorrhoea and impotency by my treatment. But I trust that 
enough have been given to satisfy the most skeptical and dis- 
heartened sufferer from these diseases, that his case is yet 
remediable. 
1835. In the whole list of diseases there is not one that is 
more neglected and less understood by physicians generally, than 
spermatorrhoea. It has, therefore, furnished a lucrative field for 
quackery. 
I am daily consulted by persons suffering from spermatorrhoea 
and impotency, and who have been victimized by ignorant charla- 
tans. The advertisements of some of these swindlers are headed 
by such captivating sentiments as “ A Retired Physician,” “ A 
Philanthropic Clergyman desiring to rescue the Unfortunate,” 
“Lost Manhood Restored,” “Avoid Quacks,” “Healing Pool,” 
or perhaps they appear under the more pretentious title of 
“Howard Association,” or “New York Medical University,” 
compared with either of which no greater humbug exists. 
Others advertise under such fictitious names as “Dr. LaCroix,” 
“ Dr. Lockrow,” or “ Old Dr. Thompson,” expressing their will- 
ingness to treat this class of diseases on the most reasonable 
terms. 
I frequently receive letters making inquiries concerning the 
reputation or professional standing of a quack who resides in 
this city and makes a practice of imposing upon unfortunate 
sufferers. He assumes the title of “ doctor ” by virtue of a 814 
COMMON SENSE MEDICAL ADVISER. 
diploma obtained from a so-called medical university of Phila- 
delphia, the charter of which has been revoked by the legislature 
of Pennsylvania, because the faculty of that institution were 
found guilty of selling diplomas to such charlatans. This pre- 
tender issues a pamphlet wherein he claims to have made great 
discoveries in physiology and medicine, intimates that he is the 
author of “ large works ” which “ may be found in all the prin- 
cipal book stores,” and makes other extravagant pretensions. 
The fact is that this little pamphlet is the extent of his author- 
ship, and in it nearly every sentence is so constructed as to be- 
tray an utter disregard for grammar. We, therefore, infer that 
he has neglected to acquire even the rudiments of a common 
school education, and if we judged of his medical qualifications 
by his lying pretensions, we should have to stigmatize him as a 
decided humbug ! 
1836. I have considered at some length the subjects of Sper- 
matorrhoea and Impotency, on account of their prevalence, and 
the very unsatisfactory manner in which they are treated by 
general practitioners. In France and Germany, where the man- 
agement of these diseases has not to such an extent been given 
over to quacks, but where they engage the attention of many 
scientific physicians, great advancement has been made in their 
treatment. Specialists in those countries have recently discov- 
ered and introduced to the profession many valuable remedies 
for these affections. Many of the medicines employed at the 
World’s Dispensary, in the treatment of spermatorrhoea and 
impotency, are imported directly from Europe, and are unknown 
to the majority of American physicians, who manifest little 
interest in discoveries relating to these diseases. 
1837. Many general practitioners assume to treat these most 
delicate and intricate diseases, but their inexperience results only 
in disappointment. With ordinary treatment, these affections 
prove very obstinate, the physician becomes tired of his patient, 
and, ydshing to be rid of him, recommends marriage as an ulti- 
mate remedy. If the patient follow this advice, domestic unhap- 
piness, and perhaps divorce, are the results. An individual 
suffering from spermatorrhoea, impotency, nervous debility, etc., 
should not marry until he has regained his health. Let him fully 
recuperate his energy and strength, that his children may not WOUNDS. 
815 
inherit any morbid sexual tendencies ! The issue of his love may 
then be pure, sweet and promising, and his home be made an 
earthly paradise. It has been said that the greatness of the 
human soul is shown by keeping within the bounds of modera- 
tion. It is a French proverb, that “the happiness of the human 
race in this world does not consist in our being devoid of 
passions, but in our learning to command them.” 
ACCIDENTS AND EMERGENCIES. 
1838. Accidents and emergencies which require immediate 
attention frequently occur. Professional aid cannot always be 
instantly obtained and hence fatal results often follow. It is, 
therefore, necessary that all persons should not only know how 
to proceed under such circumstances, but they should be able to 
exercise that deliberation and self-control so necessary in emer- 
gencies of all kinds. Most persons are more or less affected at 
the sight of blood or severe wounds, and it requires m7£-power 
to gain self-possession. One should act resolutely, otherwise he 
will find himself overcome and unable to render any assistance. 
WOUNDS. 
1839. Wounds may be classified as incised, punctured, con- 
tused, lacerated, poisoned, etc. 
Incised wounds are those which are made with a sharp, cutting 
instrument and are characterized by their extent of surface. 
Punctured wounds are- made with a pointed instrument and 
are distinguished for their depth rather than breadth. 
Contused wounds are those arising from bruises. 
Lacerated wounds are those in which the flesh is torn and 
mangled. 
Poisoned wounds are made with a poisoned instrument, or by 
some poisonous reptile, insect or rabid animal. 
In all cases of wounds the immediate danger lies in the shock 
produced upon the nervous system and in the liability to hem- 
orrhage. 
1840. Shock. If severe, it is attended with symptoms of 
extreme prostration, as feeble pulse, shivering, partial uncon- 
sciousness, fainting, hiccough, vomiting and involuntary dis- 
charges of the urine and faces. 816 
COMMON SENSE MEDICAL ADVISER. 
1841. Treatment of Shock. The clothing should 
be loosened immediately after the accident, so that the blood 
may have free circulation, and the patient should be kept in a 
recumbent position. He should have plenty of fresh air and 
may inhale camphor or ammonia. If he can swallow, stimulants 
may be given, as whisky or brandy, but with care that they do 
not run into the -windpipe. If he be unable to swallow they may 
be administered as injections, but should gradually be discon- 
tinued as reaction takes place. A warm pillow placed at the 
back and the use of electricity may be beneficial. 
1842. Hemorrhage, or bleeding, may generally be con- 
trolled by a compress, tourni- 
quet., flexion of the joint or 
styptics. A compress con- 
sists 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. 
Fig. 215. 
The Field Tourniquet as applied. 
1843. A tourniquet may tem- 
porarily be supplied by rolling 
a handkerchief into a cord and 
tying it around the limb, over 
a compress, on the side of the 
wound nearest the heart. A 
stick is then thrust between 
the handkerchief and the skin 
and twisted around several 
•times until the pressure is suf- 
ficiently great to arrest the 
circulation of the blood in the 
wounded part. A representa- 
tion of this operation may be 
seen in Fig. 215. 
1844. Flexion of the joint, 
as represented in Figs. 216, 
217, and 218, is adapted to 
many cases of hemorrhage, 
Fig. 216. 
Mode of employing flexion for the arrest of 
hemorrhage from a wound located 
below the elbow. WOUNDS. 
817 
Fig. 217. 
Mode of employing flexion for the arrest of hemorrhage from a wound 
below the knee. 
Fig. 218. 
Mode of employing flexion for the arrest of hemorrhage from a wound located 
between the thigh and knee. 818 
COMMON SENSE MEDICAL ADVISER. 
and would have saved many a soldier’s life in the late war, had 
it been employed. 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 its arterial tubes. 
1845. Styptics, in some cases, may be applied directly to the 
wounded tissues. (See Astringents, 514.) Cold acts as a 
powerful styptic, and may generally be made available for arrest- 
ing hemorrhage. 
1846. Poisoned Wountls. 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 fresh earth, raw onion, plantain, spirits of turpentine, or 
ammonia. 
1847. 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 sought. 
FRACTURES AND DISLOCATIONS. 
1848. Recovery from drowning sometimes occurs when life 
is apparently extinct. The treatment, however, should be im- 
mediate and energetic, and should be given in the open air unless 
the weather be too cold. 
DROWNING. (Asphyxia.) 
1849. Treatment. The patient should be gently placed 
upon his face with his wrist 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 
side (the right being preferable), 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—then turn 
the body gently on the side and quickly again upon the face. 
Alternate these movements about every four seconds, and SUN-STROKE. 
819 
occasionally change sides. When the body is turned on the face, 
gentle but efficient pressure must be made along the back, between 
the shoulder blades, to assist in forcing the air out, but this pres- 
sure must 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 bot- 
tles of hot water to the stomach, armpits, thighs and feet. During 
the entire process of restoration, the body should be thoroughly 
rubbed upward. Turning the body upon the back or roughly 
handling it, should be avoided. The person must not be held 
up by his feet, nor Be rubbed with salt or spirits. Rolling the 
body on a cask is improper, and injections of the smoke or infu- 
sion of tobacco are injurious. Avoid the constant application 
of the warm bath, and do not allow a crowd to surround the 
body. 
FAINTING. 
1850. When a person falls in a fainting fit, he should be 
suffered to remain in a recumbent posture, and his clothing 
should be immediately loosened. The extremities should be 
rubbed, the patient allowed to have plenty of fresh air, and, if 
at hand, ammonia or camphor should be applied to the nostrils. 
BURNS AND SCALDS. 
1851. 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. 
1852. 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 mix- 
ture composed of two to three grains of carbolic acid and two 
ounces of glycerine, or linseed oil and white lead, are all bene- 
ficial agents for the treatment of burns. If internal treatment 
be necessary it should be under the direction of a judicious 
physician. 
1853. If the patient be suffering from sun-stroke he should 
at once be removed into the shade. If his face be flushed apply 
SUN-STROKE. (Coup de Soleil.) 820 
COMMON SENSE MEDICAL ADVISER. 
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 be pale and the symptoms denote 
exhaustion, the patient should be kept in a recumbent position, 
the extremities rubbed, camphor and ammonia inhaled, mustard 
applied to the spine, and stimulants, as brandy or whisky, admin- 
istered. 
1854. POISONS AND THEIR ANTIDOTES. 
Poisons. 
Antidotes. 
ACIDS. 
Acetic Acid. 
Citric Acid. 
Muriatic Acid. 
Tartaric Acid. 
Alkalies—carbonate of soda, lime, potash, 
magnesia—are antidotes to these poisons. As 
soon as the acid is neutralized, mucilaginous 
drinks, as flax-seed, gum arabic, slippery-elm, 
etc., may be given. 
Sulphuric Acid, 
(Oil of Vitriol.) 
Soap, in solution, or magnesia will counter- 
act its influence. Water should not be given, 
as it causes great heat when mixed with this 
acid. 
Nitric Acid, 
(Aqua Fortis.) 
Oxalic Acid. 
Lime-water, carbonates of lime and magne- 
sia, in solution, are the only antidotes. Give 
mucilaginous drinks. 
Carbolic Acid. 
No special antidote. Oil, glycerine, milk, 
flour and water, whites of eggs, magnesia, and 
flax-seed tea, may be used. 
Prussic Acid. 
Laurel Water. 
Oil of Bitter Almonds. 
Ammonia, by inhalation or in solution, may 
be used. Apply cold douche to the head. 
These agents are speedily 
fatal. 
ALKALIES. 
Liquor of Ammonia. 
Water of “ 
Muriate of “ 
Vegetable acids, as vinegar, lemon-juice, 
citric and tartaric acids, neutralize this poison. 
Liquor of Potassa. 
Nitrate of ‘ ‘ 
( Saltpetre.) 
Carbonate of Potassa, 
. ( Pearlash.) 
Salts of Tartar. 
All of the fixed oils, as linseed, castor, and 
sweet oil, also almonds and melted lard, de- 
stroy the caustic effects of these poisons. Mu- 
cilaginous drinks may be given. POISONS AND THEIR ANTIDOTES. 
821 
Poisons. 
Antidotes. 
IODINE, 
In its different forms. 
Starch, wheat flour mixed with water, 
whites of eggs, milk, and mucilaginous 
drinks, are excellent antidotes. 
VOLATILE OILS AND 
AGENTS. 
Creosote, 
( Oil of Smoke.) 
Oil of Tar. 
Oil of Turpentine. 
The same antidotes as in case of poisoning 
with iodine, may he used in this, or the stom- 
ach may be evacuated with an emetic or a 
stomach-pump. 
ALCOHOL. 
A powerful emetic of white vitriol or mus- 
tard should at once be given, cold should be 
applied to the head, and the extremities 
vigorously rubbed. 
ANTIMONY AND ITS COM- 
POUNDS. 
Tartar Emetic. 
Butter of Antimony. 
Oxide of Antimony. 
If vomiting have not occurred, induce it by 
tickling the throat, and giving large draughts 
of warm water, after which administer astrin- 
gents, as infusions of galls, oak-bark, Peru- 
vian bark, or strong green tea. 
ARSENIC AND ITS COM- 
POUNDS. 
White Arsenic. 
Yellow Sulphuret of Ar- 
senic. 
Red Sulphuret of Arsenic. 
King's Yellow. 
Fly Powder. 
Arsenical Paste. 
Arsenical Soap. 
Scheele's Green. 
Paris Green. 
Oils or fats, lard, melted butter, or milk, 
should be given, then induce vomiting with 
white vitriol or hydrated peroxide of iron; 
fine powdered iron rust or magnesia, may be 
given every five or ten minutes. Mucilaginous 
drinks should be given as soon as the stomach 
is evacuated. 
COPPER AND ITS COM- 
POUNDS. 
Blue Vitriol. 
Verdigris. 
Avoid the use of vinegar. Give albuminous 
substances, as milk, whites of eggs, wheat 
flour in water, or magnesia; yellow prussiate 
of potash in solution may also be given freely. 
LEAD AND ITS COM- 
POUNDS. 
Acetate of Lead, 
(Sugar of Lead.) 
White Lead. 
Red Lead. 
Litharge. 
In lead or painters' colic, purgatives and 
anodynes may be given, together with large 
doses of iodide of potassium. 
MERCURY AND ITS COM- 
POUNDS. 
Corrosive Sublimate. 
White Precipitate. 
Red Precipitate. 
Calomel. 
Albumen in some form should be given; if 
the poison is not absorbed, follow with a mus- 
tard or lobelia emetic. 822 
COMMON SENSE MEDICAL ADVISER. 
Poisons. 
Antidotes. 
ACRONARCOTICS. 
Ergot. 
Black Hellebore. 
Veratrum, 
CAmerican Hellebore. 
Aconite. 
Fox-glove. 
Qelseminum. 
The general treatment indicated for this 
class of poisons, is to evacuate the stomach 
with a stomach-pump, or an emetic composed 
of four or five grains of tartar emetic, fifteen 
or twenty grains of sulphate of zinc, or large 
doses of mustard, repeated every quarter of 
an hour until the full effect is produced. 
Belladonna. 
Stramonium. 
Morphine, sassafras, iodine and stimulants. 
Nux Vomica. 
Strychnia. 
Large doses of camphor, chloroform and 
tobacco may all be beneficial. 
Poison Oalc. 
Poison Vine. 
Muriate of ammonia, in solution, may be 
applied externally, and from ten to fifteen 
grains given internally; soda is also useful. 
NARCOTICS. 
White Henbane. 
Opium. 
Sassafras may he used as an antidote for 
henbane. Belladonna is an antidote of opium; 
cold water should also he applied to the head 
of the patient, and the extremities should he 
well rubbed. 
ANIMAL POISONS. 
Spanish Fly. 
Potato Fly. 
Excite vomiting by drinking sweet oil. 
Sugar and water, milk, or linseed tea in large 
quantities, and emollient injections, are valu- 
able. 
OLD SORES. (Chronic Ulcers.) 
1855. Under this head we may properly consider the class of 
affections known as “Fever-Sores,” “Running Sores,” “Ulcers,” 
etc. These sores have common characteristics, yet each possesses 
certain peculiarities, which have led to their division into irrita- 
ble, indolent and varicose. (Specific ulcers, such as cancerous and 
syphilitic affections, are treated of in another portion of this 
volume.) These peculiarities are not constant — one form of 
ulcer often changing into that of another. A feature common 
to all, however, is their slowness to heal, which has sometimes 
led to the belief that they are incurable. Another popular notion 
is, that their cure is detrimental to the health of the patient. 
With equal propriety we might say that it is dangerous to cure 
diarrhoea, dysentery, consumption, or cancer. As a result of 
erroneous impressions many people suffer with chronic 
ulcers for years, and even a life-time, without obtaining relief. OLD SORES. 
823 
Chronic ulcers usually appear upon the lower extremities. The 
depth and appearance of 
the ulcer depends upon its 
character and the thickness 
of the tissues where it is 
situated. Fig. 219 repre- 
sents a chronic ulcer, or 
fever-sore, as it appeared 
upon the ankle. 
1856. The Irrita- 
ble Ulcer is painful 
and tender, the slightest in- 
jury causing it to bleed. 
It is of a dark purplish hue 
and filled with spongy, sensitive granulations. It discharges a 
thin, bloody matter, which is sometimes very fetid and acrid, and 
excoriates the tissues if it comes in contact with them. The 
edges of this species of ulcer are shelf-like and ragged, and turn 
inward. The adjacent structures are red and swollen. Very often 
severe constitutional disturbances, such as chills, fever, and 
great nervous prostration and irritability, are manifested. 
Fig. 219. 
A Chronic Ulcer. 
1857. Ill the Indolent Ulcer the edges are not un- 
dermined, hut turn outward, and are rounded, thick, glossy and 
regular. The granulations are broad, flat, pale, insensible, and 
covered with a grayish, tenacious matter. The surrounding 
parts are not very sensitive, but the limb on which it is located 
is apt to be swollen. This is the commonest form of ulcer, and 
often remains for years. 
1858. Varicose Ulcer. This form of ulcer is always 
connected with a swollen or enlarged condition of the neighbor- 
ing veins, which are very enfeebled. It almost invariably appears 
below the knee, and may be either indolent or irritable. It 
is generally sensitive to the touch, and sometimes excessively 
painful. Knots of superficial veins may often be seen beneath 
the skin. 
As I have before remarked these various species of ulcers are 
but modifications of one form of chronic sore. The patient may 
assert that he enjoys excellent health, but if we question him 
closely we find that the sore irritates him, and that there is 824 
COMMON SENSE MEDICAL ADVISEE. 
sufficient constitutional disturbance to prevent the healing 
powers of nature from effecting a cure. 
1859. Treatment. The cure of these sores is necessarily 
slow, and whoever expects to obtain immediate relief will be 
disappointed. 
1860. Constitutional treatment is of the utmost importance, 
and should, therefore, be thoroughly and persistently applied. 
The nutritive system, especially the absorbents, should be kept 
active, as these are the organs by which the broken-down tissue 
surrounding the sore is replaced by that of a higher grade of 
vitality. For this purpose the best alteratives are required. If 
secretion and excretion be not normally performed, the blood 
becomes poisoned by the absorption of unhealthy matter from 
the sore, and various constitutional disturbances occur. If 
at any time during treatment constitutional disturbances be 
manifested by fullness or disagreeable sensations in the head, 
nausea, pain, cough, chills or fever, a thorough cathartic should 
be given. If the patient be robust, a repetition of the same 
once a week will be very beneficial. My Golden Medical Dis- 
covery and Pellets will be productive of the best results. If the 
urine be scanty, or loaded with deposits, add to every other bottle 
of the Discovery one ounce of the acetate of potash and admin- 
ister according to the directions given. The skin is apt to be 
dry and will require the daily use of the alkaline bath, followed 
by a thorough rubbing, and the employment of the spirit vapor- 
bath once a week. 
1861. The local treatment must depend upon the character 
of the ulcer. If the sore he irritable, soothing applications, 
such as warm poultices, or steaming it in a vapor of hitter herbs, 
will be found highly beneficial. A poultice of powdered slip- 
pery-elm and lobelia is very soothing and hence well adapted to 
this purpose. If the ulcer be indolent, a stimulating application 
is necessary. The hardened, callous state of the edges must be 
removed by alkaline applications. A strong solution of salse- 
ratus, a lye poultice, or even a caustic, prepared by boiling the 
lye from hard-wood ashes to the consistence of syrup, will 
prove of great utility. One or two applications of the latter 
are generally sufficient. 
The sore and surrounding parts may afterwards be stimulated DISEASES OE THE BONES. 
825 
by the application of lint saturated in the compound tincture of 
myrrh (which can be obtained at any drug store). If the part 
be flabby and the granulations indolent, the application of astrin- 
gents 514), after cleansing the ulcer, is often attended with 
excellent results. An application, composed of half a drachm 
of carbolic acid and one ounce of glycerine, will greatly promote 
the healing of indolent ulcers. The sore should be covered so 
as to effectually exclude the light and air, and the dressing need 
not be changed oftener than every other day. A preparation 
known as the “ Black Salve of the American Dispensatory ” is 
both cleansing and healing, and one of the best applications 
that can be made. It is advisable to occasionally replace one 
application by another, as the constant use of any one prepara- 
tion is apt to weaken its effects. 
DISEASES OF TIIE BONES. 
1862. The bones are liable to be attacked by various dis- 
eases; we shall, however, in this connection, but briefly consider 
a few of the affections to which they are subject. 
1863. Inflammation of the Bones {Osteitis). The 
inflammation of a bone is not of usual occurrence, although it 
is occasionally to be met with. It may be caused by external in- 
juries, or by some constitutional taint, as syphilis, scrofula, 
rheumatism or gout. 
1864. Symptoms. The patient experiences a violent, 
excruciating, deep-seated, throbbing pain, which is usually more 
severe at night, and is increased by moving about. The soft 
parts over the affected bone are tender, and as the disease pro- 
gresses, become swollen. The constitution sympathizes with the 
local disease, and consequently there is hot skin, thirst and quick 
pulse. As the inflammation approaches suppuration, there are 
chills, delirium, profuse sweating, and all of the general indica- 
tions of hectic fever. 
1865. Treatment. The most skillful medical as well as 
surgical aid may be employed, and yet a long time is generally 
required to restore a diseased bone to its normal condition. The 
treatment must be prompt and energetic, or the inflammation 
will result in suppuration and destruction of the bone. Perfect 
quiet is necessary. A spirit yapor-bath should first be employed 826 
COMMON SENSE MEDICAL ADVISEE. 
and my Compound Extract of Smart-Weed may be taken in 
suitable doses. Warm fomentations or poultices, medicated with 
the Extract of Smart-Weed, may be applied to the affected part. 
The circulation must be controlled by the use of aconite 596), 
or veratrum (If 597), and if necessary anodynes may be admin- 
istered at night. 
The symptoms are less severe in the chronic form. They, 
however, resemble those of the acute, and require similar treat- 
ment, together with an alterative course of medicine. My 
Golden Medical Discovery is excellent to fulfill chronic indica- 
tions, and iodine, locally applied, is often found beneficial. 
If matter be formed it must be released, or it will burrow and 
cause an extensive destruction of tissue. All constitutional 
taints should be removed and the general health improved as 
much as possible. 
1860. Fever-Sore (JVecrosis). By the term necrosis we 
mean mortification, or the state of a bone when it is deprived of 
life. Dunglison says: “This condition is to the bone what gan- 
grene is to the soft parts;” it is popularly known as Fever-sore, 
there being no distinction made between this species of sore and 
those ulcers (see 1855) which affect only the soft tissues of the 
body. When any part of a bone becomes necrosed it is treated 
as a foreign body; nature sets about effecting its removal, and 
at the same time attempts to replace it with new and healthy 
Fig. 220. 
Hand drill for boring bone. 
materials. In consequence of this process, the dead portion is 
often inclosed in a case of new, sound bone, termed involucrum; 
when this is the case the dead portion is termed sequestrum. If, 
Fig. 221. 
however, it be superficial, and separate from the parts beneath, 
it is called an exfoliation. This healing process, by which the 
The osteotrite, for enlarging openings and cutting carious bone. DISEASES OE THE BONES. 
827 
Fig. 222. 
involucrum is formed, cannot go on to entire completion while 
the dead portion remains. Hence numerous openings are from 
time to time made through the involucrum, to 
permit the escape of the sequestrum. When a 
surgical operation is performed for the removal 
of the necrosed hone it is called sequestrotomy. 
The instruments which I usually employ for 
this practice are represented in Figs. 220, 221 and 
222. 
1867. Causes. Fever-sore may arise from 
inflammation, injuries, working in phosphorus, or 
from the inordinate and protracted use of mer- 
cury. 
1868. Symptoms. There are symptoms 
of inflammation of the bone. The pain fre- 
quently commences in the night, and all the 
different stages are passed until finally the result 
is mortification, or death. The entire bone, or 
only a part of it, may be affected; the parts be- 
come swollen, matter forms, and unless it be 
evacuated artificially, it will in time work its 
way out through a fistulous opening and thus be 
discharged. As the disease progresses the ad- 
jacent tissues become thickened and numerous 
openings are formed which communicate with 
the bone, and often with each other, so that a 
probe may be passed from one to the other, as ( 
represented in Fig. 223, copied from a drawing j 
by Dr. Howe. The discharge from fever-sore 1 
Gouge forceps for excavating bone. 
Fig. 223. 
Necrosis of the 
tibia. A common 
probe is passer! 
through the sin- 
uses. 828 
COMMON SENSE MEDICAL ADVISER. 
greatly varies in its character, and usually gives rise to a fetid 
odor. The surgeon can readily distinguish between healthy and 
unhealthy bone by the use of a probe. The pus discharged in 
necrosis contains minute particles of bone which may be felt by 
rubbing it between the fingers. Sometimes large pieces present 
themselves at the openings. The general health is seriously 
impaired, and the patient becomes debilitated, ansemic and hectic. 
1869. Treatment. The process of repair will necessarily 
be tedious, and we must assist nature by every possible means to 
remove the old bone and promote the formation of the new. An 
alterative course of treatment is indicated, and must be persist- 
ently followed. Give my Golden Medical Discovery and Pur- 
gative Pellets in sufficient doses to keep the bowels regular. 
Tonics may be necessary to encourage the nutritive functions, 
and for this purpose a preparation made from two grains of 
hydrastin 613) and five grains of phosphate of iron, taken 
three times a day, is excellent; or the pyrophosphate of iron 
618) may be given instead of the phosphate, in doses of two 
grains. All efforts to heal the sores, so long as dead bone 
remains, will prove fruitless. The sores should be thoroughly 
cleansed with injections of an alkaline solution, after which 
bandages, moistened in glycerine, may be applied. If there be 
much stench a few drops of carbolic acid may be added to the 
glycerine. The dead bone will be but slowly discharged, there- 
fore time, and indeed sometimes the life itself may be saved, by 
removing it with surgical instruments. In the operation of 
sequestrotomy the surgeon must exercise great judgment in 
respect to the extent to which it may be carried. Carelessness 
in this particular may prolong the disease and subsequently 
necessitate another operation, or perhaps an amputation. 
HERNIA. (Rupture or “Breach.”) 
1870. By the terra Hernia, we mean a tumor, which is formed 
by the displacement of the intestines, the omentum (covering of 
the bowels), or both, and which protrudes from the abdominal 
cavity. The most common varieties are umbilical, inguinal and 
femoral hernia. The tumor usually protrudes from the navel 
or groin. Children are most subject to umbilical hernia, males 
to inguinal, and females to femoral. HERNIA. 
829 
1871. Causes. These are either predisposing or exciting. 
Anything which occasions general or local muscular debility, as 
dropsy, pregnancy, abscesses, wounds, obstructions to natural 
evacuations, etc., is a predisposing cause of hernia. The excit- 
ing cause is pressure applied to the contents of the abdomen, as 
straining in evacuating the bowels and bladder, lifting heavy 
weights, or violent bodily exertion. 
1872. Symptoms. The only characteristic symptom of 
hernia is the presentation of an elastic, or doughy tumor, which 
is of variable size and sometimes gradually and again suddenly 
makes its appearance. There is flatulence, uneasiness and some- 
times pain in the abdomen. 
1873. Treatment. The treatment of hernia is by re- 
duction and retention. Reduction consists in returning the pro- 
truding intestine to its proper place through the outlet by which 
it has escaped. This is accomplished either by manipulation or 
a surgical operation. Retention is effected by wearing a mechan- 
ical appliance called a truss. 
1874. As soon as the tumor protrudes, or the “bowel comes 
down,” the patient should assume the recumbent posture, with 
his shoulders and feet elevated. The patient or an attendant 
should grasp the hernia and with gentle, but gradually increasing 
pressure upon the tumor, attempt to replace it. At the same 
time let the assistant knead the bowels upward by pressing upon 
the integument, so that the intestine may, as far as possible, be 
carried away from the point of protrusion. Sometimes the con- 
traction of the muscular fibres at the point where the hernia 
makes its exit is so great that the tumor cannot be returned. 
The system may then be relaxed by lobelia, which should not be 
given in doses to produce vomiting, and as soon as the patient is 
thoroughly under its influence, the manipulations may be re- 
sumed. When there is any difficulty experienced in putting back 
the “ breach,” or rupture, professional assistance should promptly 
be obtained. After the reduction of the rupture, a truss should 
be properly adapted, applied and constantly worn to prevent the 
protrusion of the hernia. 
1875. Surgical Treatment. When the hernia has 
become strangulated and cannot be returned by manipulation, a 
surgical operation is necessary, which, when properly performed, 830 
COMMON SENSE MEDICAL ADVISER. 
is generally successful. Whenever the necessity for such a pro- 
cedure is apparent, no time should be lost, for the greater the 
delay the greater the liability to fatal results. The operation 
consists in cutting down upon the strangulated bowel, thus 
relieving it of its constriction and facilitating its replacement. 
It is a delicate operation and must be skillfully performed. Af- 
ter the operation, the patient requires good hygienic manage- 
ment. 
1876. The radical cure of hernia is seldom accomplished, 
except by operative surgery. The object of an operation is to 
obliterate the canal through which the rupture passes. Several 
methods are pursued by different surgeons, but the one preferred 
by the faculty at the World’s Dispensary is that known as 
Agnew’s operation, which has proved very successful. 
ANEURISM. 
1877. The word aneurism literally sigmties a widening, and 
is applied to a soft tumor which arises from an unnatural dilata- 
tion or rupture of the coats of an artery. The chief danger of 
this affection is, that the arterial coats which form the walls of 
the tumor are liable to be suddenly ruptured, thereby producing 
fatal, internal hemorrhage. 
1878. Symptoms. The principal sign is a well-defined, 
oval or globular tumor, slightly compressible, elastic, and which 
pulsates with every beat of the heart. 
1879. Treatment. This consists in tying the artery 
between the tumor and heart, or in applying pressure oyer the 
artery. Pressure may be made in various ways, but must be 
continued for a considerable length of time, in order to be effec- 
tual. If the artery be tied, a cure, in most cases, will speedily 
result. This operation is more or less difficult, according to the 
location of the aneurism. Operative surgery has, however, been 
brought to such perfection during the past half century, that 
almost any blood-vessel in the body may be safely and success- 
fully tied, thus effectually obviating all immediate danger which 
may arise from aneurism. THOUGHTS ADDRESSED TO INVALIDS. 
831 
Fig. 22J/.. 
World’s Dispensary.—The Author’s Private Office. 
THOUGHTS ADDRESSED TO INVALIDS. 
1880. The invalid reader may be desirous of learning more 
concerning my professional resources for treating the sick. 
Once I could have the individual oversight of all my patients, 
and attend personally to the adaptation of medicines. But my 
practice and correspondence increased until I was obliged to em- 
ploy professional and other assistants. The most thoroughly 
educated physicians, who have had experience in general prac- 
tice are engaged, and after remaining with me until they become 
experts in some one branch of medicine or surgery, assist in 
examining and prescribing in that department. To one belongs 
the examination and treatment of diseases of the nervous sys- 
tem; to another surgical operations and the treatment of surgical 
diseases; a third has charge of catarrhal and pulmonary diseases, 
and affections of the heart; a fourth attends to diseases peculiar 
to women; a fifth to diseases of the eye and ear; and to 
others are entrusted diseases of the urogenital organs. These 
physicians daily confer with the author, who supervises the 
entire medical and surgical practice. All doubtful, obscure or 
difficult cases are submitted to a Council composed of the 
Medical Staff of physicians and surgeons—the Faculty of the 
World’s Dispensary. Skilled pharmaceutists are employed to 
compound the medicines prescribed. Likewise a physician, 
who is also a skillful chemist, is constantly engaged in analyzing 83 2 
COMMON SENSE MEDICAL ADVISER. 
Fig. 225. 
World’s Dispensary.—One of the Rooms Occupied by the Medical Faculty. 
urine. He thus detects the exact morbid changes which it has 
undergone in certain obscure diseases, and can unequivocally 
indicate the class of remedies required for restoration. Several 
gentlemen are also employed as recording and filing clerks. 
For the purpose of enabling us to conduct our extensive corres- 
pondence, stenographers are employed to whom replies are 
dictated and by them taken down in short-hand. Afterwards 
the letters are written out in full, generally on a type-writing 
machine, which prints them in plain, legible 
style. These machines are operated as rap- 
idly as a person can think of the letters that 
compose a word, each operator thus accom- 
plishing the work of several copyists. This 
system, by which we are enabled to corres- 
pond with our patients as rapidly as we can 
talk, has been rendered necessary by the 
growth of our business, which has attained 
immense proportions, giving rise to so large a correspondence 
that a dozen physicians could not possibly conduct it all and 
give each patient’s case careful attention, without the employ- 
ment of short-hand writers and all other facilities which modern 
invention has given us. By the adoption of all these various 
means, we are enabled to fully meet the demands of the public, 
give every case the most careful attention, and render advice 
and prescribe remedial agents of greater intrinsic value than gold. 
Fiq. 226. 
Type Writer. ADVANTAGES OP SPECIALTIES. 
833 
Fig. 227. 
World’s Dispensary.—One of the .Reception Rooms. 
1881. As many persons, particularly young ladies and gentle- 
men, having catarrh or other chronic diseases are very sensitive 
and fearful that somebody will know that they are afflicted and 
employing medical treatment, precautions are taken that none 
who consult us may incur the least risk of exposure. Although 
none but the most honorable and trustworthy gentlemen are em- 
ployed as assistants, yet as a guarantee of perfect security to 
our patients, that every communication, whether made in person 
or by letter, will be treated as sacredly confidential, each profes- 
sional associate, clerk and assistant is required to take a solemn 
oath of secrecy. Great care is also taken to send all letters and 
medicines carefully sealed in plain envelopes and packages, that 
no one can even suspect the contents or by whom they are sent. 
1882. Advantages of Specialties. While for a 
long time my study and practice has been confined to the inves- 
tigation and treatment of chronic diseases (having entirely given 
up the management of acute diseases and the practice of mid- 
wifery), my professional associates in the World’s Dispensary 
have a still more restricted field of labor. 
1883. By thorough organization and a perfect system of 
subdividing the practice of medicine and surgery in this institu- 
tion, every invalid consulting us is treated by a specialist—one 
who devotes his undivided attention to the particular class of 
diseases to which his or her case belongs. The advantage of 
this arrangement must be obvious. Medical science offers a vast 834 
COMMON SENSE MEDICAL ADVISER. 
Fig. 228, 
'World’s Dispensary.—One of the Consultation Kooms. 
field for investigation, and no physician can, within the limit of 
a single life-time, achieve the highest degree of success in the 
treatment of every malady incident to humanity. A- distin- 
guished professor in the medical department of one of our 
universities, in an address to the graduating class, recently said: 
“ Some professional men seem to be ashamed unless they have 
the character of universal knowledge. He who falls into the 
error of studying everything will be certain to know nothing 
well. Everv man must have a good foundation. He must, in 
the first place, be a good general practitioner. But the field has 
become too large to be cultivated in its entirety by one indi- 
vidual. Hence the advantage of cultivating special studies in 
large towns which admit of the subdivision of professional pur- 
suits. It is no longer possible to know everything; something 
must be wisely left unknown. Indeed, a physician, if he would 
know anything well, must be content to be profoundly ignorant 
of many things. He must select something for special study 
and pursue it with devotion and diligence. This course will 
lead to success, while the attempt to do everything eventuates 
unavoidably in failure. Let there be single hands for special 
duties.” The diversified tastes and talents of physicians cause 
each to excel in treating some one class of diseases to which he 
devotes more attention and study than to others. One medical 
student manifests great interest in the anatomy, physiology, 
pathology and treatment of diseases of the eye. He becomes ADVANTAGES OP SPECIALTIES. 
835 
Fig. 229. 
World’s Dispensary.—Medical Council -Hoorn. 
thoroughly familiar with all the minutest details relative to that 
organ and its diseases, and so thoroughly qualifies himself in this 
branch of knowledge, that he is able to cure an inflammation or 
other affection of the eye in a very short time. Another student 
is more interested in some other class of diseases for the study of 
which he has a liking, and neglects to inform himself in the 
ophthalmic branch of medical and surgical science. If, after 
engaging in the practice of his chosen profession, he is consulted 
by persons suffering from diseases of the eye, he tortures them 
with unnecessary and ofttimes injurious applications, clumsily 
and carelessly made, and as the result of such unskillful treat- 
ment, the inestimable blessing of sight is many times sacrificed. 
The great majority of physicians allow acute maladies, dis- 
eases of children and the practice of midwifery to engross most 
of their time and attention. They manifest an absorbing in- 
terest in everything that relates to these subjects, and devote 
little or no time to acquiring an intimate knowledge of the great 
variety of chronic maladies which afflict mankind. They acquire 
skill and reputation in their favorite line of practice, but are 
annoyed if consulted by one suffering from some obscure chronic 
affection, usually turn the invalid off with a very superficial ex- 
amination, and, perhaps, only prescribe some placebo,* appa- 
rently indifferent as to the result, but really desiring thus to 
* A “placebo” is a harmless and valueless prescription, which physicians some- 
times make merely to gratify the patient, as a dose of ‘‘bread pills,” etc. 836 
COMMON SENSE MEDICAL ADVISER. 
Fig. 230. 
World’s Dispensary.—Prescription Department. 
conceal their lack of familiarity with such diseases. The spe- 
cialist, the treatment of chronic diseases being his vocation, is 
equally annoyed if consulted by those suffering from acute dis- 
eases, but does not pursue the inconsistent course of assuming 
to treat them. He refers them to those of his medical brethren 
whose'daily dealings with such cases make them, in his way of 
thinking, more competent than himself to render valuable ser- 
vices to such sufferers. He recognizes the fact that no man is 
likely to succeed in any line of study or business for which he 
possesses no talent or relish, nor does he believe in being a 
“ jack of all trades and master of none.” 
1884. Advertising. Having thoroughly qualified him- 
self for the practice of some particular branch of the healing 
art, the specialist sees no impropriety in acquainting the public 
with his ability to relieve certain forms of suffering. He be- 
lieves that medical men should possess equal rights with other 
business men, and that any code of medical ethics which would 
deprive him of any of the sacred rights guaranteed to all by the 
liberal laws of our country, is professional tyranny and merits 
only his contemptuous disregard. Nor does he display any false 
modesty in the manner of making known his skill. He main- 
tains that he has an undoubted right to place his claims to 
patronage before the public by every fair and honorable means. 
He recognizes the display of goods in the merchant’s show win- 
dows as no less an advertisement and in no better taste than the ADVERTISING. 
Fig. 231. 
World’s Dispensary.—Counting. Room. 
publication of a card in the newspaper. So likewise he regards 
the various devices by wThich the extremely ethical physician 
seeks to place himself conspicuously before the public, as but so 
many ways of advertising, and as not more modest than the 
publication of cures actually performed, or than his announce- 
ment through the public press of his professional resources for 
treating certain maladies. (See 677, page 390.) 
1885. The physician who expresses a “ holy horror ” of the 
“ advertising doctor,” liberally bestowing upon him the epithet 
of quack, announces himself a graduate, talks learnedly and 
gives notice to the public in some w'ay that he is ready to serve 
them. He endeavors to impress upon the mind of the patient 
and family his skill, frequently exaggerates as to the extent of his 
practice, rides furiously about when he has no professional calls, 
keeps up business appearances by driving several horses, or joins 
influential societies. He may make a great display in style, 
manner, dress, pretensions, writing for the newspapers, exhibiting 
literary pedantry, referring to the superior facilities afforded by 
some particular school or society to which he belongs; or by 
editing and publishing a medical journal, ostensibly for the ad- 
vancement of medical science, but practically to display titles or 
professorships, to publish reports which flatteringly allude to 
cases he has treated, the number of capital surgical operations 
he has performed, or the distinguished families he is treating. 
All of these are but modes of advertising professional wares; in 838 
COMMON SENSE MEDICAL ADVISER. 
Fig. 232. 
World’s Dispensary.—Advertising Department. 
short, are artful, though not refined tricks, resorted to for pri- 
vate announcement. We say to all such adventurers in modern 
advertising diplomacy, that these indirect, clandestine methods 
are not half so candid and honorable as a direct public state- 
ment of the intentions and proposals of a medical practitioner, 
who thereby incurs an individual responsibility before the law 
and his fellow man. 
1886. No good reason has ever been assigned why any well- 
educated physician, trained in the school of experience until he 
becomes proficient in medical skill, may not publish facts and 
evidence to disclose it, especially when these are abundant and 
conclusive. The following extract from an able article by the 
Rev. Thomas K. Beecher embodies a sound view of the subject 
of medical advertising. He says: * * “I am glad that the 
doctor cured him; I am glad that the doctor put it in the paper 
that he could cure him. And if any doctor is certain that he 
can cure such diseases and don’t put it in the paper, I am sorry. 
What a pity it would have been had this doctor come to town 
with his wealth of science and experience and gone away leaving 
him uncured ! What a pity it would have been if he had been 
so prejudiced against advertising as to read the responsible cer- 
tificates of the doctor and give him the go-by as a quack. What 
are newspapers for, if not to circulate information ? What more 
valuable information can a newspaper give than to tell a sick 
man where he can be cured ? If a man has devoted his life and ADVERTISING. 
Fig. 233. 
World’s Dispensary.—One of the Manufacturing Chemist’s Rooms. 
labor to the study of a special class of diseases, the necessity for 
his saying so becomes all the more pressing. His duty to adver- 
tise becomes imperious. 
When I was in England, I found on all the dead walls of Lon- 
don, placards, declaring that Dean Stanley, Chaplain to the 
Prince of Wales, would preach at such a place; that his grace 
the Archbishop (I think) of Canterbury would preach at another 
time and place; again, that an Oxford professor would preach. 
In short, religious notices were sprinkled in among the theater 
bills, and the highest church dignitaries were advertised side by 
side with actors, singers and clowns. Of course, I was shocked 
by it, but in a moment I bethought me—if it be all right and 
dignified to hire a sexton to ring a bell when the minister is going 
to preach, it is all the same to silence the bell and hire a bill 
sticker to tell the same news, the essential thing being to tell 
the truth every time. The remedy for the lying advertisements 
is for honest men to tell the truth. When iniquity cometh in 
like a flood, then the spirit of the Lord lifts up the standard. A 
really able man, whatever be his gifts, makes a great mistake if 
he fails to use those gifts through want of advertising.” 
1887. If a physician possesses knowledge that enables him to 
remedy diseases heretofore regarded as incurable, what virtue or 
modesty is there to “ hide his light under a bushel ? ” In this 
free country the peoplp think and act for themselves and hence 
all have a deep concern in the subject of health. 840 
COMMON SENSE MEDICAL ADVISER. 
Fig. 28J-f. 
World’s Dispensary.—Drug Mills. 
The strong popular prejudice against doctors who advertise is 
due to the fact that, by this method, so many ignorant charlatans 
are enabled to palm off their worthless services upon the ignor- 
ant and credulous; but the practice of such imposition should 
not cause a presumption against the public announcement of 
real skill, for the baser metal berars conclusive evidence that the 
pure also exists. 
Every step in scientific investigation, every proposition which 
relates to the interest and happiness of man, every statement 
and appeal involving a valuable consideration, must be submitted 
to the scrutiny and judgment of individual reason; for every 
person has the right to form his own conclusions, and justify 
them by experience. Those claims which ai'e only supported by 
empty assertion are very doubtful. Misty theories vanish before 
the sun of truth. He who renders professional services cannot 
be successful, unless he is sustained by real merit. 
1888. An Extensive Medical Practice. Without 
being egotistical, I may say that, probably, no other physician 
in any country is constantly treating so many cases of chronic 
diseases as myself. During my practice, I have expended many 
hundred thousands of dollars in advertising in American and 
foreign journals. In this manner, I have become extensively 
known as a specialist in the treatment of chronic diseases, and 
many thousands of persons suffering from these affections have 
been led to consult me. A large experience in such cases has TREATING PATIENTS WHO RESIDE AT A DISTANCE. 
841 
Fig. 235. 
World’s Dispensary.—One oi the Percolating and Filtering Booms. 
naturally led to the discovery of many new and valuable remedies 
and improved surgical methods, which have enabled me to suc- 
ceed in multitudes of cases where others have failed. 
1889. Treating Patients who Reside at a 
Distance. We can treat most chronic diseases as success- 
fully without as with a personal consultation, as our vast 
experience enables us to correctly determine the malady from 
which the patient is suffering—by a history of the symptoms, 
and answers to the questions found in the concluding pages of 
this volume. We have never seen one person in five hundred 
whom we have cured. 
1890. Some may suppose that a physician cannot obtain, 
through correspondence, a sufficiently accurate idea of the con- 
dition of a patient, to enable him to treat the case successfully. 
But a large experience in this practice has proved the contrary 
to be true, for some of the most remarkable cures have been 
effected through the medium of correspondence. In most long- 
continued cases, the patient has thought over his symptoms 
hundreds of times. The location of every pain, whether acute 
or mild, constant or occasional, and the circumstances under 
which it occurs, have been carefully noted. lie has observed 
whether he had a rush of blood to the head, was feverish or 
chilly, whether troubled with cold hands and feet, whether full 
of blood, or pale and bloodless; and he states these matters with 
accuracy and common sense when writing to me, for he has a 842 
COMMON SENSE MEDICAL ADVISER. 
Fig. 236. 
World’s Dispensary.—One of the Storage Tank Rooms. 
very good, if not a professional knowledge of the relative im- 
portance of these symptoms. So in regard to digestion, he states 
what kinds of food agree with him, or whether he be troubled 
with excessive acidity or a flatulent condition of the stomach. 
He also informs us whether his tongue be coated or clean and 
healthy, and gives us many other particulars, too lengthy to 
enumerate, by which we are enabled to gain a perfect under- 
standing of the case. If his description be not sufficiently 
complete to enable us to obtain an unmistakable understanding 
of the case, he is requested to answer a list of important ques- 
tions which are sent him. The people are far more intelligent 
in these matters than physicians are generally willing to admit. 
A patient is often confused while being personally examined by 
a physician, and gives imperfect or incorrect answers. After he 
has left the presence of the physician, he finds that he has failed 
to enumerate many of the most important symptoms. In con- 
sulting by letter, the patient is not embarrassed, states the exact 
symptoms, and carefully reads over the letter to see if it is a 
complete and accurate description of his sufferings. In this way 
he conveys a much better idea of the case than if present in per- 
son, and subjected to the most thorough questioning and “ cross- 
examination.” The timid lady and nervous young man write 
just as they feel; and one important reason Avhy we have had 
such superior success in treating intricate and delicate diseases, URINARY SIGNS. 
843 
Fig. 237. 
World’s Dispensary.—One of the Labeling and Wrapping Kooms. 
is because we have obtained such true and natural statements of 
the cases from these letters, many of which are perfect pen 
pictures of disease. As bank-tellers and cashiers, who daily 
handle large quantities of currency, can unmistakably detect 
spurious money, by a glance at the engraving or a touch of the 
paper, so the experienced physician, by his great familiarity with 
disease, becomes equally skilled in detecting the nature and 
extent of a chronic malady from a written description of its 
symptoms. 
1891. Urinary Signs. A careful microscopical examina- 
tion and chemical analysis of the urine is a valuable aid in deter- 
mining the nature of many chronic diseases, particularly those of 
the nervous system, blood, liver, kidneys, bladder, prostate gland 
and generative organs. This important fact is not overlooked 
at the World’s Dispensary, where an experienced chemist is em- 
ployed to make such examinations and report the result to the 
attendant physicians. Medical authors, professors and practi- 
tioners of all schools, admit and even insist upon the importance 
of such examinations in diagnosing diseases. Many practitioners 
neglect to take advantage of this invaluable aid, while many 
others fear that if they attach much importance to such examina- 
tions they will be ranked with “ uroscopian ” or “ water doctors ” 
—a class of enthusiasts who claim to correctly diagnose every 
disease by an examination of the urine. Persons consulting us, 844 
COMMON SENSE MEDICAL ADVISEE. 
and wishing to avail themselves of the advantages afforded by 
these examinations, can send small vials of their urine by mail. 
The vials should be carefully packed in saw-dust or paper and 
Fig. 288. 
The Binocular Microscope used at the World’s Dispensary. 
inclosed in a light wooden box. All charges for transportation 
must be prepaid, and a complete history of the case, including 
the age and sex of the patient, accompany each package, or it 
will receive no attention. This saves valuable time by directing 
the examination into the channels indicated, and thus avoiding U BINARY SIGNS. 
845 
Fig. 239. 
World’s Dispensary.—Packing and Shipping Room. 
a lengthy series of experiments. As we are daily receiving 
numerous vials of urine, to prevent confusion, every sample 
should be labeled with the name of the patient who sends it. 
1892. There is a natural, definite proportion of the compo- 
nent elements of every solid and fluid of the human body. 
These proportions have been reduced to definite standards, a 
deviation from which bears evidence of disease. Thus, there 
being a fixed standard in the normal proportion of the elements 
of the blood, any deviation 
from it, as in anaemia, leuco- 
cythaemia, etc., indicates dis- 
ease. So also the standard 
proportion of the urinary 
elements being known, any 
considerable change, either 
in the quality or quantity of 
its parts, bears unmistakable 
evidence of disease. 
1893. The invention of 
the microscope has provided 
increased facilities for de- 
tecting diseases by examina- 
tions of the urine. By the aid of this wonderful instrument 
we are enabled to discover with absolute certainty the various 
Fig. 2J/J. 846 
COMMON SENSE MEDICAL ADVISER. 
Fig. 
World’s Dispensary.—Stock of Empty Bottles. 
urinary deposits characteristic of different maladies; for example, 
in Fig. 240, a represents the residue of normal human urine, 
as seen under the microscope. In division b, is represented 
oxalate of urea. An excess of this element indicates indigestion, 
and is also characteristic of a plethoric or full habit of body. 
Nitrate of urea is represented in division c. A deficiency of 
urea in the renal secretion is a certain indication of anaemia. The 
average quantity present during health is 21.57 parts in 1,000. 
The microscopical examina- 
tion of the urine, notwith- 
standing the distaste, and 
even contempt, which many 
physicians manifest for such 
investigations, is pursued at 
the World’s Dispensary with 
inestimable benefits to our 
patients. It lias revealed 
the existence of many seri- 
ous affections, which, with 
all our other modes of inves- 
tigation, we had been una- 
ble to detect. It has also 
thrown light upon many obscure chronic diseases. 
1894. I have already spoken of the marked changes effected 
in the urine by a derangement of the digestive functions. It is 
jFig. 2If. URINARY SIGNS. 
847 
Fig. 2^3. 
World’s Dispensary.—Boiler Boom. 
a matter of surprise to me that physicians generally pay so little 
attention to the urine when dyspepsia is suspected, since all 
admit that an examination of that excretion furnishes unmis- 
takable evidences of the nature and complications of the disease. 
In this way we are many times enabled to determine whether 
the indigestion be caused by congestion or functional disease of 
the liver or kidneys, or by nervous debility. And when such 
cases are treated in accordance with the indications furnished, 
increased success attends 
our practice. In Fig. 242 
(divisions a and b) highly 
magnified urinary deposits, 
which indicate different de- 
grees of impairment of the 
digestive functions, are rep- 
resented. The crystals seen 
in division c indicate the 
same debility accompanied 
by derangement of the men- 
tal faculties. Those seen in 
divisions d and e indicate 
still more aggravated forms 
of the same disorder. 
1895. The various forms of gravel, Bright’s disease of the 
kidneys, hematuria, inflammation of the kidneys and bladder, 
Fig. 2U. 848 
COMMON SENSE MEDICAL ADVISER. 
Fig. 2Jf5- 
AVorld’s Dispensary.—Compositors’ ltoom. 
diabetes, and other functional and organic diseases of the urinary 
organs, effect characteristic changes in the urine, thus enabling 
us to distinguish them with certainty. Some of the various 
microscopic appearances of the urinary deposits in diseases of 
the kidneys and bladder, are represented in Fig. 244. In division 
a, is represented pus and mucus, the presence of which indicates 
suppuration of the kidneys. In b, pus globules are alone repre- 
sented. In the division marked c are shown blood corpuscles as 
they are arranged in blood 
drawn from a vein or artery. 
d represents the same sepa- 
rated, as they always are 
when present in the urine. 
In e, highly magnified oil 
globules are represented. If 
present in the urine, they 
indicate disease of the kid- 
neys. In the division marked 
f are represented epithelial 
cells, the presence of which 
in large numbers is indica- 
tive of disease of the mu- 
cous lining of the urinary organs. 
1896. Fig. 246 represents the microscopic appearance of 
phosphates in the urine. By attaching the camera lucida to the 
Fig. %Jf6. URINARY SIGNS. 
849 
Fig. 2J+7. 
microscope we can throw an image of these urinary deposits 
upon paper. By the art of the engraver this image may 
he faithfully traced, and thus we are enabled to produce 
an accurate representation of them. Some of the beautiful 
crystalline deposits shown in Fig. 246 represent less than a mil- 
lionth part of a grain, yet their forms are delineated with 
geometrical precision. In division a are represented uri- 
nary crystals which indi- 
cate an irritable state of the 
nervous system. The crystals 
shown in division b are of 
the same character as the 
preceding, but bear evidence 
of greater mental debility. 
In division c are represented 
crystalline deposits indicat- 
ing malassimilation of food 
and a tendency to hypochon- 
dria. Division d contains a 
representation of the mixed 
phosphates. They are indic- 
ative of severe diseases attended by hypochondria and general 
nervous prostration. 
1897. Fig. 248 represents the microscopic appearance of 
World’s Dispensary.—Room where Pellets are Manufactured. 
Fig. 2Jf8. 850 
COMMON SENSE MEDICAL ADVISER. 
Fig. 2Jf9. 
World’s Dispensary.—Boom where Nasal Douches are Manufactured. 
mixed urinary deposits. In division a are represented the mixed 
urates as they appear during idiopathic fevers, as intermittent, 
remittent, etc. When appearing as seen in division b, a less 
violent affection of the same character is indicated. Division c 
represents urate of ammonia, occasionally observed when there 
is a tendency towards albuminuria, or dropsy, resulting from 
granular degeneration of the kidneys. In division d is repre- 
sented urate of soda, which is present in the urine of persons 
suffering from gout. The 
crystals shown in division is 
consist of the same salt. 
1898. In division A, Fig. 
250, is represented the mi- 
croscopic appearance of pur- 
ulent matter in the urine. 
The absorption of pus from 
abscesses in different parts 
of the system, is frequently 
followed by the appearance 
of pus globules in the urine. 
When fat globules—repre- 
sented in division b—are 
found in the urine, they indicate fatty degeneration. In division 
c are representations of the cells found in the urine of persons 
suffering: from consumption and other scrofulous diseases. 
Fig. 250. URINARY SIGNS. 
851 
Fig. 251. 
World’s Dispensary.—Printing Department. 
1899. Fig. 252 represents the different forms of cystine found 
in the urine of scrofulous persons. In division a it is represented 
as seen in an amorphous (non-crystallized) form, and in b as it 
appears in crystals. In division c is a representation of the 
deposits seen in the urine of those who are greatly debilitated. 
In division d are seen epithelial cells mixed with mucus. 
1900. In division a, Fig. 
253, are represented the 
caudated cells characteristic 
of hard cancer. The cells 
represented in division b are 
concentric, and characteristic 
of the soft varieties of cancer. 
1901. Fig. 254 represents 
the appearance of spermato- 
zoa as seen in urine. When 
present, they afford indispu- 
table evidence of the escape 
of semen in the renal excre- 
tion. (See article on Sperm- 
atorrhoea, page 793 of this volume.) I might add many other 
illustrations of urinary deposits and state their several indications, 
but a sufficient number have been introduced to show the im- 
portance and practical value of microscopical examinations of the 
urine in distinguishing obscure diseases. 
Fig. 252. 852 
COMMON SENSE MEDICAL ADVISEE. 
Fig. 253. 
1902. Although the microscope is of inestimable value, it does 
not entirely supersede other valuable instruments and chemical 
re-agents, in determining the constitutional changes in the renal 
excretion. By the urinometer we determine the specific gravity 
of the urine; by the use of litmus its acid or alkaline reaction is 
ascertained; while various chemicals, when added to it, produce 
certain specific changes, according to the alterations which it has 
World’s Dispensary.—Pamphlet Binding Department. 
Fig. 25Jf 
Fiq. 255. 
undergone. By the application of heat, or the addition of a few 
drops of nitric acid, the albumen which is invariably present in 
Bright’s disease of the kidneys, is coagulated. By the employ- 
ment of other re-agents we may determine the presence of sugar UKINARY SIGNS. 
853 
—a characteristic of diabetic urine. And thus I might enumerate 
many chemical tests by which the several changed conditions of 
the urine, characteristic of different diseases, may be ascertained 
with absolute certainty. 
1903. Dr. Eberle, a distinguished allopathic author, thus 
writes: “Whatever may be the disease, the urine seldom fails in 
furnishing us with a clue to the principles upon which it is to be 
treated.” 
Dr. Braithwaite also says: “We can arrive at a more accurate 
knowledge respecting the nature of diseases from examining the 
urine than from any other symptom.” 
Golding Bird, whose writings are regarded as sound and prac- 
tical by the most learned of the medical profession, says that, 
“ The examination of the urine in disease is now regarded as one 
of the most important aids in diagnosis, and which it would be 
alike injurious to the welfare of the patient as to the credit of 
the practitioner to avoid.” 
The eminent Dr. F. Simon writes as follows: “From the 
physical and chemical state of the urine, the attentive and ob- 
serving physician may obtain a great quantity of information 
for ascertaining and establishing a diagnosis. More than all 
other signs, the correct examination of the sediment is of im- 
portance to the physician.” * * * 
“ For the medical man it is the compass which guides him in 
the unlimited chaos of disease and its treatment; for the patient 
it is the thermometer of his condition, the premonitory indica- 
tion of the decrease or aggravation of his malady; and for the 
healthy man it is the regulator of his diet and of his life.” 
“ Every one is aware of the variations of the barometer, and 
we know that the fluctuations of the column of mercury are 
closely associated with the variable conditions of the atmos- 
phere; so, to the practiced observer, variations of the urine, as 
well as the elements composing it, point out with certainty the 
changes in health and the condition of the organs.” 
1904. While we recognize the importance of examining the 
urine as an aid in distinguishing diseases, and have made this old 
German method of diagnosis a special study, yet we do not 
claim that all diseases can be unmistakably distinguished by such 
examinations alone. We take a conservative position and have 854 
COMMON SENSE MEDICAL ADVISER. 
no confidence in that class of ignorant fanatics whose pet 
“hobby” is “uroscopy.” From every person who solicits our 
professional services we require answers to the questions herein- 
after given, that we may know the age, sex, vocation, etc., as 
well as the prominent symptoms manifested. 
1905. Consultations by Letter. Persons desiring 
to consult me will please answer, as briefly as possible, such of 
the following questions as appertain to their respective cases. It 
will not be necessary to repeat the questions, but only to number 
the answers to correspond with the numbers hereafter prefixed 
(in parenthesis) to the different series of questions. 
QUESTIONS TO INVALIDS. 
(1.) What is your name? What is the name of your post- 
office? In what County and in what State do you reside? 
Where is your nearest express office ? 
(3.) What is your age ? What is the color of your hair and 
eyes ? What is your complexion ? What is your height ? 
What is your present weight ? What is your weight when in 
health ? Is your neck short, average length, or unusually long ? 
In what country were you born ? What is your occupation ? 
Have you been a hard worker ? Do you labor now ? 
(3.) Have your ancestors been long lived ? Are your 
parents living; if so, what are their ages? Are they healthy? 
If either or both be dead, of what did they die ? Is there any 
hereditary disease in the family? Do you suspect tempera- 
mental incompatibility in your parents ? If you do not fully 
comprehend this question, before attempting to answer it, read 
the article entitled “Transmission of Life,” commencing on page 
182 of this volume. Should you not then be able to answer it 
satisfactorily, describe the personal appearance of each of your 
parents. If you have lost near relatives, of what did they die ? 
Have you any brothers or sisters, and if so are they healthy ? 
(4.) How long have you been out of health ? What do you 
think was the cause of your disease? From what particular 
symptom do you suffer most ? 
(*5.) Do you experience any fever, chills, or night-sweats ? 
How many times does your pulse heat per minute when quiet in 
the morning, and how many times in the evening? Do you QUESTIONS TO INVALIDS. 
855 
have cold feet and hands ? Does your heart at times beat ex- 
citedly and more strongly than usual ? Are its pulsations 
irregular, fluttering or weak ? Are you plethoric (full of blood) 
or anaemic (bloodless and pale) ? 
(6.) Is your skin soft and moist, or rough and dry ? Is it 
clear, yellow, or in anywise discolored? Is the white of your 
eyes unnaturally yellow? Have you any eruptions, blotches, 
pimples or sores upon your skin ? If so describe them. 
(7.) Do you suffer from any severe trouble of mind; if so 
what is the cause? Have you ever had convulsions (fits) or 
spasmodic affections of any kind ? Have you at any time been 
severely frightened or suffered for a long time from great 
anxiety or fear ? Have you ever overtasked yourself with study 
or other severe mental labor ? Is your memory weakened ? 
Have you ever met with any severe disappointments which 
nearly or quite prostrated you ? Do you sleep well ? Do you 
experience frightful or disagreeable dreams? Do you often 
have amorous or lascivious dreams ? Do you feel stupid and 
drowsy during the day ? Do you cry from trivial causes ? 
(8.) Have you ever met with any accident that caused sick- 
ness, lameness or severe pain ? If so, what ? Was it followed 
by any deformity ? Have you any swellings or tumors ? If so, 
where are they located and how long have you had them ? Have 
you hernia (rupture), swellings or enlargements in the groin, 
thigh, abdomen (belly), or elsewhere ? If so, do they disappear 
when you lie down ? Do they protrude more when you cough, 
sneeze or strain ? Do you feel strong, or weak ? How far can 
you walk without experiencing fatigue ? When you run is there 
an oppressed feeling in your lungs ? Is your flesh soft and flabby, 
or firm ? Do you enjoy exercise, or do you avoid it as much as 
possible ? 
(9.) Are you regular in all your habits ? Do you retire at 
night and rise in the morning at regular hours'? Do you drink 
strong tea or coffee? Do you use opium? Do you smoke, chew, 
dip or snuff tobacco ? Do you use alcoholic or other stimulants ? 
Do you eat freely of rich pastries, pickles or fat pork ? Do you 
eat late suppers ? Do you think you have injured yourself by 
indulging in any bad habit ? If so, what habit ? 
(10.) Do you suffer from pain in your head ? If so, what is 856 
COMMON SENSE MEDICAL ADVISER. 
the character of the pain ? Is it dull and heavy, or sharp and 
lancinating? Is it in the front, back or sides of the head, on one 
or both sides, in the face, or just over or in the eyes? Do you 
have dizzy or oppressed sensations ? Do you ever feel as if there 
was a rush of blood to your head ? Do you suspect that you 
have catarrh? If so, state if there is any obstruction in the 
nasal passages, or a discharge falling into the throat. Is the dis- 
charge profuse, watery and acrid, or thick and tenacious? State 
if it is purulent (mattery), bloody, putrid or offensive ? Are the 
nasal passages dry? Are your eyes weak or inflamed? Do 
you experience ringing in the ears or deafness? Is there any 
ulceration in the ears, roof of the mouth, or throat? Are 
there scales or lumps of hardened matter discharged from the 
ulcers ? Has your voice a “ nasal twang ” ? Is your breath 
offensive and your sense of smell or taste impaired ? 
(11.) Is your sight good ? Are your eyes weak or inflamed ? 
Do you imagine that there are specks, sparks, streaks, or flashes 
of light, mists, or clouds, floating before you ? Can you see best 
in a bright light or when it is dim, as at twilight ? Are your 
eyes frequently full of tears, and if so, do the tears overflow the 
lower lids and trickle down your cheeks ? Are both eyes thus 
affected ? Do your eyelids become gummed or glued together 
during sleep ? 
(12.) Can you hear well ? Do you have any discharge from 
the ears ? Do you experience ringing or roaring sounds ? 
(13.) Is your tongue coated? If so, is it white, yellow, or 
of a dirty brown color ? Is it coated all over the upper surface, 
or only in patches ? Are there deep furrows, wrinkles, red points 
or small elevations like pimples on the upper surface of the 
tongue? Is the mouth unusually dry ? Any unpleasant taste? 
Are any of your teeth decayed ? Is your breath offensive ? 
(14.) Are your bowels loose, costive, or regular? (How 
often do they move ?) Have you any bloating of the abdomen 
(belly), or any soreness noticeable in that region ? Have you 
been in the habit of taking cathartics? Do you suffer from piles ? 
If so, are they external, internal, blind, bleeding or itching? 
Have you anal fistula ? If not able to answer the last question, 
read the symptoms of that affection found on page 606. 
(13.) Does your food digest well? Do you have sour, QUESTIONS TO INVALIDS. 
857 
watery or windy eructations (risings) from the stomach? Do 
you have any pain, “ gnawing,” burning, soreness, feeling of 
emptiness, or trembling in the region of the stomach ? Are you 
frequently troubled with nausea or a distressing sensation of 
fullness and heaviness in the stomach ? What kinds of food 
distress you most ? Are you low-spirited and hypochondriacal 
(subject to the “ blues ”) ? 
(16.) Are you suffering from any affection of the throat? 
Is your throat sore ? Is there an enlargement of the tonsils, or 
any tickling or choking sensation in the throat ? Are you 
troubled with hoarseness, weakness or suppression of the voice ? 
(17.) Do you take cold easily? If so, where does it affect 
you most ? Have you a cough ? If so, does it trouble you most 
at night, soon after retiring, or in the morning ? If you suspect 
that your lungs are affected, state how much you measure around 
your chest when your lungs are filled with air, and also what is 
the measure after the air is exhaled. Do you feel any weakness, 
tenderness or pain, in the chest? Do you expectorate (raise) 
much ? If so, does the expectorated matter float upon or sink 
in water ? Is it streaked with blood ? Do you ever have attacks 
of bleeding from the lungs ? Are your feet and ankles swollen ? 
Do you occasionally have chills ? Do you have night-sweats ? 
Are you “ round-shouldered,” and inclined to stoop when walking 
or sitting? Did you ever have typhoid, bilious, remittent or 
intermittent fever (fever and ague, or chills and fever) ? 
(18.) Have you weakness, soreness, lameness, or pain in the 
lower part of your back ? Do you have any pain or soreness in 
the region of the bladder or lower extremity of the bowels ? 
Do you have a desire to urinate often ? If so, how often, and 
how much urine is voided at a time ? Do you suffer pain or a 
smarting sensation in passing it ? Does it contain any sediment ? 
If so, is the sediment white, red, brown or yellow ? Does it 
settle to the bottom of the vessel and feel gritty ? Does pus 
(matter), blood or gravel, pass with the urine ? Is the urine of 
a white and milky, red, yellow, or natural color? Have you 
ever had any venereal disease (gonorrhoea or syphilis) ? If so, 
how did it affect you ? Did you have any sores upon your geni- 
tal organs ? If so, how many and where were they situated ? 
Do you still have any perceptible symptoms resulting from that 858 
COMMON SENSE MEDICAL ADVISER. 
infection ? Do you have any unnatural discharge from the 
genital organs ? Do you experience any burning pain or scalding 
sensation on passing urine ? Is there any obstruction to the flow 
of urine ? Does the urine sometimes suddenly stop flowing ? If 
so, will it flow freely if you lie on your side or back and then try 
to void it ? 
(19.) Do you suffer any pain, weakness, soreness, numbness, 
or other disagreeable sensations, in any part of your body ? If 
so, where, and what is its character ? 
(30.) Are you single or married ? If married, state how 
long you have been married, and if your companion be healthy. 
Have you children; and if so, are they strong and healthy? If 
you have no children, do you desire them ? Is the barrenness 
supposed to be the fault of the husband or wife, or both ? If 
children are desired describe your own and also your partner’s 
eyes, hair, complexion, height, weight and age ? Does the gen- 
eral outline of the forehead of one differ greatly from that of 
the other ? Head the articles in this volume on Barrenness, or 
Sterility and Impotency and then give me any information that 
you may think is important in enabling me to determine the 
cause of your unfruitfulness. 
(31.) If a male, state if you have seminal emissions at night; 
if so, how often ? Do you have a discharge of semen when at 
stool? Does the semen pass off with the urine? Are these 
emissions the result of self-abuse (masturbation), excessive sex- 
ual intercourse, or both? Is the erectile power enfeebled, or 
wholly lost, or are the erections perfect ? (If married), is the 
semen prematurely discharged when you have sexual intercourse? 
Were you troubled with emissions before you were married? 
Are your testicles diminished in size, swollen, enlarged, painful 
and tender, or do they feel like a mass of earth-worms in the 
scrotum ? Have you a very strong desire for sexual inter- 
course, or is your amative passion weakened by disease ? Are you 
gloomy and despondent? Are you nervous and easily irritated ? 
(33.) If a female, are you troubled with leucorrhcea (whites)? 
If thus afflicted, state what is the consistency, color, etc., of the 
discharge. Do you have a bearing down, or dragging sensation 
in the region of the womb ? If married, state if sexual inter- 
course gives you pain. Is there any apathy or lack of amative QUESTIONS TO INVALIDS. 
859 
excitability on your part during sexual intercourse ? Are you 
troubled with excessive amative desires? Are your menses 
(“monthly courses”) regular in their appearance? How often 
do they occur and how long does the discharge continue ? Do 
you suffer pain before, during or after the flow, and is the dis- 
charge slight, profuse or moderate in quantity ? Do you suffer 
from irritation, smarting, soreness or itching of the vagina or 
external genital parts ? If you have children, state how many, 
also if they are healthy, and give the age of the youngest. 
Have you had any miscarriages ? If so, how many, and at what 
period of pregnancy did each occur, and was it due to accidental, 
medicinal or surgical causes? Are you pregnant? If so, how 
long have you been pregnant ? Are you nursing a child ? Did 
you recover rapidly after confinement ? Do you feel any tender- 
ness on pressing firmly over the womb ? Have you practiced 
self-abuse or indulged excessively in sexual intercourse ? 
(23.) Is the locality in which you reside considered healthy ? 
Do chills and fever (fever and ague) ever prevail in your 
neighborhood? Have you ever taken much mercury or been 
salivated ? If your disease is one for the cure of which my 
proprietary medicines are recommended, state if you have em- 
ployed them; if so, which ones, and how much have you taken 
of each ? Have you a complete volume of the “ People’s 
Common Sense Medical Adviser ” ? I ask this question, as it 
is a matter of great convenience to me, when I can refer to cer- 
tain passages in that work as answers to your questions, thereby 
giving you the requisite information. 
1906. Many questions in the preceding list may appear, to 
the casual reader, unimportant or trifling, yet they are of the 
greatest moment in determining the nature and extent of dis- 
ease. From answers to such questions as “what is the color of 
your hair, eyes and complexion”? I must form my opinion of 
your temperament or constitutional organization. From your 
answers to other questions I must determine the peculiarities and 
perhaps complications of your disease. If the answers are accu- 
rate, I can judge as correctly of the nature and extent of a 
disease as if permitted to make the most careful personal 
examination. 
1907. The questions are only suggestive. In writing, mention 860 
COMMON SENSE MEDICAL ADVISER. 
only those symptoms which you experience. To each group of 
answers prefix a number corresponding to that of the group con- 
taining the question answered. Do not attempt to answer a 
group of questions by simply saying “ yes ” or “ no,” but state 
your symptoms clearly and fully. And while condensing and 
making the history of your case as brief as is consistent with 
clearness, you are not limited to answering the above questions, 
but may make any further remarks which you think will throw 
light upon your case. If you have a complete volume of “ The 
People’s Medical Adviser,” and find therein an accurate descrip- 
tion of your disease, state the page and paragraph where it 
appears. If you do this, it will be unnecessary to state your 
symptoms. If convenient, it is well to enclose your photograph 
with the answers to questions, for although by no means impor- 
tant in all cases, yet useful information is sometimes gained 
therefrom. 
1908. Reliable Medicines. Next in importance to 
a correct understanding of the patient’s disease, is the possession 
of reliable remedies for its treatment. Many of the medicines 
employed by physicians engaged in general practice are pre- 
pared from old drugs that have lost all their medicinal virtues, 
and hence are utterly worthless and ineffectual. Many vegetable 
extracts are inert, because the plants from which they are pro- 
duced, were not gathered at the proper time. To give the reader 
an idea of the great care which we exercise in the selection and 
preparation of our medicines, he is requested to read page 309 
of this volume. 
1909. Fees for Consultation. It requires consider- 
able time to read a letter detailing symptoms, and generally 
much longer to carefully consider, weigh and interpret these 
signs of disease. Then a complete record of the case must be 
made for future reference, and a carefully written reply must be 
sent. After considering these facts every reasonable person will 
see the propriety of advancing a slight compensation; yet the 
small fee expected for this labor is required more as an evidence 
of the patient’s confidence and good faith in consulting us than 
as a remuneration for services rendered. Those who have not 
sufficient confidence in us to advance the small sum of one dollar 
—the fee required for simple consultation by letter—must not WHY OUR FEES ARE REQUIRED IN ADVANCE. 
861 
expect us to pay any attention to their communications. We 
cannot spend hours and days in reading and writing letters 
merely to satisfy the idle curiosity of any person. If the con- 
sultation by letter involves a microscopical and chemical examin- 
ation of urine, the fee will be three dollars, and must be remitted 
in advance, or the communication will receive no attention. 
1910. I am frequently consulted by persons contemplating 
matrimony, as well as by those already married, who desire to 
have me examine the temperaments of the two parties, as repre- 
sented in their photographs, and give my opinion of their adap- 
tation or compatibility. To avoid extra correspondence, I will 
here say that a fee of five dollars must accompany each letter 
requesting such information. The photographs furnished for 
this purpose should be quarter or profile views. They should 
also be accompanied with a description of each party, the color 
of eyes, hair, complexion, etc. (See page 182.) 
1911. Our Fees for Office Consultations vary 
from one to five dollars, according to the time occupied and the 
nature of the necessary examinations. 
1912. Our Terms for Treatment require the pay- 
ment of monthly fees (in advance) which entitle the patient to 
medicines specially prepared for and adapted to his or her par- 
ticular case, and to all necessary attention and advice. Our fees 
for treatment are moderate, varying according to the nature and 
requirements of each particular case, and will be made known at 
the time of consultation. 
1913. Why Our Fees are Required in Ad- 
vance. We receive applications from strangers residing in 
all parts of America, and even from foreign countries, and it is 
not reasonable to suppose that credit could be dispensed so in- 
discriminately. It would not be a correct business transaction 
for a merchant to send a barrel of sugar or a roll of cloth to a 
stranger living hundreds of miles away, to be paid for when 
used. My knowledge and medicines constitute my capital in 
business, and an order upon that capital should be accompanied 
by an equivalent. Some applicants refer me to their neighbors 
for a testimonial of their integrity. I cannot spare the time nor 
employ assistants to make such inquiries for the sake of trusting 
any one. Should credit be thus indiscriminately given there 862 
COMMON SENSE MEDICAL ADVISER. 
would necessarily be losses, and, to compensate for these, and 
the extra expense incurred by the employment of assistants, our 
fees would have to be much larger, thereby imposing the burden 
upon those who do pay. Instead of following this method of 
procedure, we place professional services within the reach of all, 
so that a greater number may be benefited. Many invalids say 
that they have paid large sums of money to medical men for 
treatment without obtaining relief. Unfortunately our land is 
cursed with quacks and unprincipled practitioners, who seek no 
one’s good but their own, and it is a defect in our laws that they 
permit such swindlers to go unpunished. Not so reprehensible 
is the family physician who fails, because his limited and varied 
practice does not permit him to become proficient in treating 
chronic diseases. 
1914. Two diplomas, received from leading medical colleges, 
certify to my attainments in Medicine and Surgery. An immense 
experience, affording unusual opportunities for the investigation 
of disease and the adaptation of medicines, has enabled me to 
succeed in innumerable instances where eminent medical men 
have failed. The following beautiful sentiment of Hood truth- 
fully expresses the sacredness of the physician’s trust: 
“ Above all price of wealth 
The body’s jewel. Not for minds or hands profane 
To tamper with in practice vain. 
Like to a woman’s virtue is man’s health; 
A heavenly gift within a holy shrine! 
To be approached and touched with serious fear, 
By hands made pure and hearts of faith severe, 
E’en as the priesthood of the One Divine.” 
I am in regular practice, responsible for what I say and do, 
and cordially invite those who want further evidence of my 
success in curing chronic diseases to come to the World’s Dis- 
pensary and satisfy themselves of the truthfulness of my state- 
ments. 
1915. Some applicants offer to deposit a certain amount of 
money with a third party to be paid to us when cured. Even if 
the science of medicine were exact, like chemistry or mathe- 
matics, we could not in justice to ourselves treat patients upon 
this condition. We could never know whether our medicines 
were taken as prescribed or not, and even after the patient was INVALIDS MUST NOT BE IMPATIENT. 
completely restored to health he might apply all sorts of impru- 
dent tests, believing that a cure should withstand everything. 
Besides, we could not guard against the wiles of the applicant 
and his money-holder, who might feel disposed to defraud us. 
We choose to avoid all difficulties of this character, believing 
that the “ laborer is worthy of his hire.” When the physician 
exercises his skill in diagnosing disease, and adapting remedies 
and furnishes medicines, there should be no equivocation con- 
cerning his fee. 
1916. We are warranted in saying that our responsibility, 
and disposition for fair dealing, are known by many of the 
principal mercantile houses, as well as by all prominent Ameri- 
can editors. We also refer to our present and former patients, 
one or more of whom may be found in almost every hamlet of 
America. To all who are under our treatment, we devote our 
highest energies and skill, fully realizing that an untold blessing 
is conferred upon each person whom we cure, and that such 
cures insure the permanency of our business. On the contrary, 
we realize how unfortunate it is for us to fail in restoring to 
health any person whom we have encouraged to hope for relief. 
We are careful, therefore, not to assume the treatment of in- 
curable cases, except when desired to do so for the purpose of 
mitigating suffering or prolonging life; for we never wish to 
encourage false hopes of recovery. 
1917. Invalids must not be Impatient. Chronic 
diseases can only be cured gradually. As a large structure, the 
erection of which cost years of labor, may be hastily torn down, 
but will require the same length of time to rebuild it,—to x-eplace 
brick upon brick,—so the physical system may become shattered 
by disease, and will require the slow and steady process of medi- 
cation to rebuild it, cell by cell, and tissue upon tissue, until the 
structure is again complete. 
1918. It may happen that the patient has an attack of some 
acute disease shortly after beginning to use my remedies. He is 
inclined to attribute this disease (which is the result of undue 
exposure) to my medicines, and sometimes finds dishonest physi- 
cians who will encourage and confirm him in this erroneous 
belief. It may happen that the patient will feel a little worse 
for a few days after beginning to use my medicines. When 864 
COMMON SENSE MEDICAL ADVISER. 
your foot is “ asleep,” the circulation in that member is stopped, 
and it has no feeling. If you try to restore the lost sensibilities, 
the blood begins to circulate and you experience many peculiar 
and disagreeable sensations : so the unpleasant symptoms which 
often follow the use of efficacious medicines, are due to a sudden 
awakening of the vital functions. Persons who commence to 
use my remedies should have a mind of their own and a deter- 
mination to persevere, and give my medicines a fair trial, not 
allowing their minds to be influenced by events which may occur 
under any circumstances, nor permitting themselves to be preju- 
diced by those who know nothing of me, or the success attending 
my practice. 
1919. Visiting Patients who Reside at a 
Distance. I am frequently asked to visit patients residing 
hundreds of miles away, so that I may personally examine their 
cases, consult with the attendant physician, or perform difficult 
surgical operations. As my time is valuable and very fully 
occupied, I cannot always comply with such requests. Having 
a larger number of physicians on my Medical and Surgical Staff 
than formerly, I shall (when not able to attend in person) detail 
a competent member of the Faculty of this institution to 
respond to such demands upon our skill. 
1920. To Physicians wishing to consult me in intricate 
cases of chronic diseases under their care, I desire to say that 
I shall, as in the past, take pleasure in responding to their solici- 
tations. Every letter requesting such advice must contain a 
complete history of the case to be examined and also a proper 
remuneration for my services. I cannot comply with the nu- 
merous requests which I receive from members of the medical 
profession to aid them by my suggestions in difficult cases with- 
out a fair compensation for the time I would spend in attending 
to their wants. I have all the necessary instruments and ap- 
pliances required in executing the most difficult surgical opera- 
tions, and as I have had much experience in this department, 
I am always ready and able to assist physicians who do not 
practice operative surgery. In this age of railways and tele- 
graphs medical or surgical aid can be summoned from a distance 
and promptly obtained. INDEX. 
A 
Abdominal Salivary Gland,... 46 
Abortion, 752 
Abscess, Lumbar, .... 441 
Abscess, Psoas, 441 
Absence of the Ovaries, . . . 714 
Absence or Malformation of the Womb, 
712 
Absorption, 49 
Abuse of the Male Reproductive Or- 
gans, 788 
Accidents and Emergencies, . . 815 
Acetabulum, .27 
Acetate of Potash, .... 346 
Acid Bath, 372 
Acids, 317 
Acids, Vegetable, 343 
Acne, 702 
Aconite, 353 
Acute Articular Rheumatism, . . 428 
Acute Bronchitis, 506 
Acute Catarrh, 463 
Acute Diarrhoea, 549 
Acute Enteritis, 546 
Acute Gastritis, 535 
Acute Hepatitis, 564 
Acute Inflammation of the Liver, . 564 
Acute Laryngitis, 482 
Acute Peritonitis, .... 647 
Acute Pleurisy, 516 
Acute Suppression of the Menses, . 718 
Adhesion of the Lids,... 678 
Adipose Tissue, .... 22 
Advantages of Specialties,. . . 833 
Advertising, 836 
Affections of the Hair-Follicles, . 701 
Affections of the Tympanum, . . 682 
Afterbirth 227 
Ague, 407 
Air, Pure, 233 
Albuminuria, 768 
Alcohol, 356 
Alkalies, 317 
Alkaline Bath, 372 
Alkaloid Atropia, 320 
Allopathic, Regular, or Old School of 
Medicine, 294 
Alnuin, 313 
Aloes, 335 
Alphos, 700 
Alphous Affections, .... 700 
Alteratives 311 
Alternate Generation, .... 17 
Amaurosis, 664 
Amenorrhoea, 712 
American Colombo, .... 360 
American Hellebore, .... 354 
American Poplar, .... 357 
Ammonia, 356 
Anaemia, 421 
Anal Fistula, 606 
Analysis of Physiological Functions 
and Temperaments, . . . 187 
Aneurism, 830 
Angina Pectoris, 527 
Animal Faculties, .... 126 
Anise Seed, 333 
Anodynes, 318 
Anteflexion of the Uterus,. . . 757 
Anteversion of the Uterus,. . . 758 
Anthelmintics, 321 
Anthrax, 463 
Antidotes, 820 
Antiperiodics, 323 
Antiseptics, 325 
Antispasmodics, 326 
Aperients, 334 
Apnoea, 422 
Apoplexy, 616 
Aptflae, 494, 530 
Aqua Ammonia, 356 
Areolar Tissue, 21 
Aromatic Sulphuric Acid, . . . 318 
Arteries, . ...... 59 
Ascites, 424 
Asclepin, 340 
Aspen Poplar, 323 
Asphyxia, 818 
Assafetida, 326 
Asthma, 519 
Asthma-Weed, 347 
Astringents, 328 
Atresia Pupillaris, . . . .662 
Atrophy, 525, 797 
Atropin, 320 
Auditory Nerves, Paryalsis of the . 684 
Auscultation, 392,494 
Author’s Afhdavit, .... 810 
IS 
Baked Mutton, 255 
Balmony, 322 
Baptisin, 326 
Barbers’ Itch, 702 
Barosmin, 343 
Barrenness, 735 
Base Ball, 278 
Basilar Faculties, ..... 128 
Bed, 283, 378 
Bedding, 380 
Beef Soup, 254 
Beef Tea, 382 
Belladonna, 320 
Beverages, 255 
Bile, 78 
Biliary Calculi, 578 
Bilious Colic, 557 
Bilious Diarrhea a, .... 549 
Bilious Disorder, 566 
Bilious Fever, 408 
Bilious Headache, .... 631 
Biliverdine, 79 
Biology, 9 
Blackberry-Root, 328 
Black Cohosh, .... 313, 348 
Black Pepper, 356 
Black-Root, 335 
Black Snake-Root, . . . 313, 348 
Bladder, Stone in the .... 772 
Blennorrhcea, 782 
Blood, Physifcal and Vital Properties, 54 
Blood-Root, 314 
Bloody-Flux, 556 
Blue Flag, 315 
Boiled Meat, 254 
Boil-like Affections 704 866 
INDEX. 
Boils, 462 
Bones, 21 
Bones of the Head, .... 24 
Bones of the Lower Extremities, . 29 
Bones of the Trunk, .... 25 
Bones of the Upper Extremities, . 27 
Boneset, 324, 346 
Bowels, Inflammation of the . . 546 
Boxing, 278 
Boxwood, 358 
Brain, 98 
Branny Tetter, 688 
Breach, 828 
Bread, 255 
Brewers’ Yeast, 343 
Bright’s Disease of the Kidneys, . 768 
Broiled Steaks, 254 
Bronchia, 62 
Bronchitis, ...... 468 
Bubo, 785 
Buchu, 343 
Bugle-Weed, 331 
Bullous Affections, .... 697 
Burdock, 312 
Burns and Scalds, .... 819 
Burs® Mucos®, 30 
Butterfly-Weed, 340 
Butternut, 335 
Butter-Weed, 332 
C 
C®cum, 43 
Calculi, Vesical . . . . .772 
Camphor,....... 320 
Canada Fleabane, 332 
Cancer, 449 
Canker, 530 
Capillaries, 60 
Carbolic Acid, 325 
Carbonate of Iron, . . . .361 
Carbonic Acid, 82 
Carbuncles 463 
Carcinoma, 533 
Cardiac Dropsy, 424 
Carminatives, 333 
Carpus, 28 
Cartilaginous Tissue, .... 22 
Castor Oil, 335 
Cataract, 667 
Catarrhal Conjunctivitis, . . . 643 
Catarrh Remedy, Dr. Sage’s . . 475 
Catechu, 329 
Cathartics, 334 
Catnip, 340 
Caustics, 339 
Cayenne Pepper, 356 
Cephalalgia, 630 
Cerebellum, 98 
Cerebral Physiology, . . . .110 
Cerebro-Spinal Meningitis, . . 615 
Cerebro-Spinal System, ... 88 
Cerebrum, 99 
Cessation of the Menses, . . .727 
Chamomile, 357 
Chelonin, 322 
Chicken-Pox, 414 
Chills and Fever, 407 
Chimaphilin, 344 
Cholagogues, 334 
Cholera, 579 
Cholera Infantum, .... 583 
Cholera Morbus, 582 
Cholesterine, 79 
Chorea, 626 
Choroid 103 
Chronic Articular Rheumatism, . 429 
Chronic Bronchitis, . . . .507 
Chronic Conjunctivitis, ... 650 
Chronic Diarrhoea, .... 552 
Chronic Enteritis, .... 546 
Chronic Form of Bright’s Disease, . 768 
Chronic Gastritis, .... 536 
Chronic Inflammation and Ulceration 
of the Womb, 740 
Chronic Inflammation of the Bladder, 774 
Chronic Inflammation of the Eyes, . 650 
Chronic Inflammation of the Iris, . 660 
Chronic Inflammation of the Kidneys, 767 
Chronic Inflammation of the Liver, . 566 
Chronic Inflammation of the Stomach, 536 
Chronic Hepatitis, .... 566 
Chronic Laryngitis, .... 482 
Chronic Kasai Catarrh, . . . 465 
Chronic Peritonitis, .... 548 
Chronic Ulcers, 822 
Circulatory Organs, .... 57 
Citrate of Iron, 362 
Clap, 780 
Clavicle, 28 
Cleanliness, .... 274,285,380 
Climate, 249 
Climatic Influences, .... 289 
Clitoris, 217 
Closure of the Pupil, .... 662 
Clothing, 264,380,473 
Coccyx 27 
Coffee, 260 
Cold Bath, 363 
Colic, 557 
Collinsonin, 345 
Colloid Cancer, 453 
Colombo, American, .... 360 
Colon, 43 
Colts-Tail, 332 
Column® Carne®, .... 58 
Comedones, 702 
Common Alder, 312 
Common Salt, 322 
Comparison of Male and Female, . 215 
Compounding of Alteratives, . . 316 
Compress, 816 
Compression of the Intestinal Canal, 561 
Conception, Double .... 226 
Conception, Prevention of . . .224 
Congestion of the Brain, . . . 613 
Conjugal Love, 195 
Conjugal Unity, 185 
Constipation, . .... 589 
Consultations by Letter, . . .853 
Consumption, 468, 487 
Consumption, Curability of . . 495 
Consumption, Exciting Causes of . 490 
Consumption, Predisposing Causes of 490 
Continued Fever, 409 
Contused Wounds, .... 815 
Cookery, 253 
Cool Bath, 364 
Cornea, Inflammation of the . . 654 
Cornea, Opacities of the . . .656 
Cornea, Ulceration of the . . .657 
Comeitis, 654 
Corium, .68 
Corns, 705 
Corpora Olivaria, 93 
Corpora Pyramidalia, .... 93 
Corpora R'estiformia, .... 93 
Corpus Callosum, 99 
Coryza, 463 
Costiveness, 589 
Cough, 494 500 
Countenance, 395 
Counter-Irritants, . .... 339 
Coup de Soleil, 819 
Cowper’s Gland, 218 INDEX. 
867 
Cow-Pox, 413 
Coxalgia, 442 
Cramp Bark, 328 
Cranesbill, 330 
Cranial Capacity of Human Kaces, . 135 
Cranium, 24 
Creatine and Creatinine, ... 82 
Creosote, 325 
Cricket, 278 
Criminal Abortion, . . . .753 
Cross-Eye, 672 
Croup, 484 
Crow-Foot, 330 
Crusted Tetter, 691 
Culver’s Physic, 335 
Culver’s-Root, 335 
Cuticle, 69 
Cypripedin, 328, 352 
Cystitis, 774 
D 
Damp Cellars, 238 
Dancing, 279 
Dandruff, 688 
Deadly Nightshade, . . . .320 
Deafness 468, 681 
Debility, 494 
Decoctions, 311 
Dedication, 3 
Development of the Individual, . 201 
Development of the Testicles in the 
Abdomen, 788 
Diabetes, 769 
Diagnosis, Medical . . . .391 
Diaphoretics, 339 
Diaphragm, 34 
Diarrhoea, 501 
Diet, 381, 473 
Digestibility of Food, .... 252 
Digestive Organs, .... 39 
Dilatation of the Heart, . . . 524 
Dilatation of the Stomach,. . . 533 
Diluents, 342 
Dioecious Reproduction, . . .213 
Dioscorein, 328 
Diphtheria, 416 
Diseased Ovaries, Fallopian Tubes, 
etc., 739 
Disease of the Prostate Gland, . 797 
Diseases Affecting the Digestive 
System, 529 
Diseases and their Remedial Treat- 
ment, 387 
Diseases of the Bones, . . .825 
Diseases of the Ear, . . . .678 
Diseases of the Eye, .... 643 
Diseases of the Heart, . . .521 
Diseases of the Liver, . . .562 
Diseases of the Skin, .... 685 
Diseases of the Stomach, . . .532 
Diseases of the Throat, . . .467 
Diseases of the Urinary Organs, . 766 
Diseases Peculiar to Woman, . . 710 
Disinfectants, 325 
Dislocations, 818 
Disorders Incident to Pregnancy, . 765 
Displacements of the Womb, . . 755 
Distilled Liquors, .... 264 
Diuretics, 343 
Dog Button, 358 
Dog-Fennel, ' . 342 
Dogwood, .358 
Domestic Management of Fevers, . 405 
Dose, Medicine 308 
Double Conception, .... 226 
Douche Bath, 370 
Dover’s Powder, 319 
Drastics, 334 
Dropsies, 423 
Dropsy of the Scrotum, . . 424, 797 
Drowning, 818 
Dryness of the Ear, .... 684 
Duodenum, 42 
Dura Mater, 89 
Dust and Disease 239 
Dysentery, 656 
Dysmenorrhcea, 719 
Dyspepsia, 469, 539 
Dyspnoea, 494 
E 
Earache, 678 
Ear, Diseases of the . . . .678 
Eating, 243 
Eating too much, 244 
Eclectics, 296 
Ecthyma, 704 
Ectropium, 676 
Eczema, 686 
Eczematous Affections, . . . 686 
Ejaculatory Duct, 218 
Electric Bath, 368 
Elongation of the Neck of the Womb, 738 
Emaciation, 494 
Emetics, 346 
Emetic-Weed, ..... 347 
Emmenagogues, 348 
Emotive Faculties, .... 122 
Encephalic Temperament, . . 175 
Encephaloid Cancer, .... 453 
Endocarditis, 526 
Enlargement of the Prostate Gland, 776 
Enteric Fever, 409 
Enteritis, 546 
Entropium, 677 
Enuresis, 775 
Epidemic Cholera, .... 579 
Epidermis, 69 
Epididymitis, 782 
Epilepsy, 620 
Epithelioma Cancer, . . . .452 
Epsom Salts, 336 
Erect Carriage, 276 
Eruptive Fevers, 410 
Erysipelas, 415 
Erythema, 695 
Erythematous Affections, . . .695 
Esophagus, 41 
Eupatorin, .... 324, 343, 346 
Eversion of the Lids, . . . .676 
Evidences of Curability of Sperma- 
torrhoea and Impotency, . . . 808 
Examination of the Urine, . . 399 
Excrescences of the Lids, . . .676 
Excretion, 81 
Exercise, 383 
Expectorants, 349 
Expectoration, 494 
Extensive Medical Practice, . . 840 
External Ear, 105 
External Piles, 597 
Eye, 399 
Eye, Diseases of the .... 643 
F 
Fainting, 819 
Falling of the Lower Bowel, . . 603 
Falling of the Uterus,.... 755 
Fallopian Tubes, .... 217, 739 
False Measles, 415 
Fascia, 32 
Fatty Degeneration of the Heart, . 525 
Favorite Prescription, . 348,352,362 
Favus, 701 868 
INDEX. 
Fecundation, 222 
Fees for Consultation,. . . 860, 861 
Felon. 708 
Female Weakness, . . . .755 
Femoral Hernia, 828 
Femur, 29 
Fencing, 278 
Fennel-Seed, 333 
Fermented Beverages, . . .263 
Fever, 403 
Fever and Ague, 407 
Fever-Sore, .... 435, 822, 826 
Fibrous Tumors, 763 
Fibula, 29 
Field Tourniquet 816 
Fish, Boiled, 254 
Fissure of the Anus, . . . .611 
Fits, 620 
Fistula in Ano, 606 
Fistula, Lachrymal .... 674 
Flatulent Colic, 558 
Flax-Seed, 343 
Flexions and Versions, . . .756 
Flexions and Versions of the Womb, 739 
Flexion of the Joint, . . . .816 
Follicular Ulcer, 761 
Fomentations, 373 
Food, Beverages, Clothing, . . 243 
Food, Different Kinds Required, . 246 
Food, Necessary Variety of . 248 
Food, Principles of ... 248 
Food, Properties of . . .249 
Food, Quantity Necessary, . . .252 
Food, Relative Values of . . .250 
Food, Value of Animal . . .249 
Foot Bath, 
Foreign Bodies in the Eye, . . 671 
Fractures, 818 
Fraserin, 360 
Functional Diseases of the Heart, . 521 
Furuncular Affections, . . .704 
Furunculus, 462 
G 
Gallic Acid, 333 
Gall-Stones, . . . ■ . . . 578 
Galvanic Bath, 369 
Gamboge, 334 
Garget, 312 
Gastralgia, 537 
Gastric Juice, 77 
Gastritis, 535 
Gelatiniform Cancer, .... 453 
Gelsemin, 328, 355 
General Considerations, . . . 134 
General Dropsy of the Heart, . . 526 
Gentian, 357 
Geranin, 330 
Geranium, Spotted, .... 330 
Germ Cell, 11 
Ginger, 333, 341 
Glaucoma, 663 
Gleet, 782 
Glycosuria, ...... 769 
Goitre, 460 
Golden Medical Discovery, 316, 324, 362 
Golden Saffron, 340 
Golden Seal, . . . . . .359 
Gold Thread, 361 
Gonorrhoea. . . . . . 778, 780 
Gonorrhoeal Ophthalmia, . . . 646 
Gout, 432 
Gravel, 771 
Gravel-Plant, 344 
Gravel-Root, 343, 344 
Gravel -Weed, 343 
Granular Conjunctivitis, . . .652 
Granular Litis, 652 
Granular Ulcer, 760 
Great Sympathetic, . . . 94, 95 
Grubs, 702 
Gum Arabic, 343 
Gutta Rosacea, 692 
Gymnasium, Exercises of the . . 279 
II 
Hair, 71 
Hair-Follicles, Affections of the . 701 
Hamamelin, 329 
Hardhack, . . . . . 331 
Haversian Canals, .... 23 
Hay Asthma, 479 
Hay Catarrh, 479 
Hay Fever, 479 
Headache, 630 
Head Bath, 371 
Hearing, 105 
Heart, 57 
Heat Eruption, ...... 686 
Hectic Fever, 494 
Hellebore, American, .... 354 
Hellebore, Swamp, .... 354 
Hellebore, White, 354 
Hemoptysis, . . . . . 494, 501 
Henbane, 319, 350 
Hermaphroditic or Dioecious Repro- 
duction, 209 
Hemorrhage, 816 
Hemorrhoids, 596 
Hernia, 828 
Herpes, 697 
Hickory-wood Ashes, . . . .343 
High Cranberry, . . . . . 328 
Hip-joint Disease, .... 442 
History of Marriage, . . . .197 
Hives, 696 
Homoeopathic Tinctures, . . . 310 
Homoeopathy, 295 
Hops, 320, 352 
Hordeolum, 675 
Horse-Balm, 345 
Horse-Radish, 339 
Hot Bath, 365 
How to put Children to Bed, . . 284 
How to use Vaginal Injections, . 734 
How to use Water, . . . .259 
Human Temperaments, . . . 146 
Humerus, 28 
Humid Tetter, 686 
Hydragogues, 334 
Hydrarthrus, 443 
Hydrastin, 359 
Hydrocele, 424, 797 
Hydrocephalus, 424 
Hydrogen, Iron by .... 361 
Hydropathy 297 
Hydro thorax, 424 
Hygiene, 233 
Hygiene Defined, 233 
Hygiene of the Reproductive Organs, 287 
Hygienic Advice to Patients, . . 804 
Hygienic Treatment of the Sick, . 375 
Hyoscyamin, 319, 350 
Hy08cyamus, 319 
Hypertrophy, 524, 797 
I 
Icterus, 577 
Ileum, 43 
Impacted Faeces, 560 
Impaired Vision, 664 
Imperforate Hymen, .... 713 
Impetigo, 691 
Impotency, 798 INDEX. 
869 
Impotency, Medical Treatment of . 806 
Incised Wounds, 815 
Incompatible Marriage, . . . 184 
Incontinence of Urine, . . . 775 
Indian Hemp, 351 
Indian Physic, 335 
Indian Poke, 354 
Indian Tobacco, ...... 347 
Indigestion, 469 
Indigo, Wild, 326 
Indolent Ulcer, 823 
Induration of the Walls of the Stom- 
ach, 534 
Infants, Feeding 245 
Inflammation, 400 
Inflammation of the Brain and its 
Membranes, 614 
Inflammation, General Principles for 
Treatment of .... . 403 
Inflammation of the Bladder, . . 774 
Inflammation of the Bones, . . 825 
Inflammation of the Bowels, . . 546 
Inflammation of the Cornea, . . 654 
Inflammation of the Iris, . . . 659 
Inflammation of the Kidneys, . . 766 
Inflammation of the Lids, . . . 675 
Inflammation of the Stomach, . . 535 
Inflammation, Termination of . . 402 
Influence of Food, . . . .288 
Influenza 463, 464 
Infusions, 310 
Ingrowing Toe-Nails, . . . .706 
Inguinal Hernia, 828 
Innominata, 27 
Insanity, 633 
Intermittent Fever, .... 407 
Internal Piles, 597 
Interpretation of Symptoms, . . 395 
Intestinal Canal, Obstruction of the . 559 
Intestinal Juice, 78 
Intestines, 42 
Introduction to Part IV., . . . 387 
Introductory Words, .... 7 
Intussusception, 559 
Invagination, 559 
Invalids must not be Impatient, . 863 
Inversion of the Lids,. . . .677 
Iodide of Ammonium, . . . . 315 
Iodide of Iron, 315 
Iodide of Lime, 315 
Iodide of Potassium, . . . .315 
Iodine, 315 
Iodine Bath 
Ipecac, 
Iridin, 
Iritis, 659 
Iron,. 361 
Iron by Hydrogen, .... 361 
Iron, Carbonate of .... 361 
Iron, Citrate of 362 
Iron, Muriated Tincture of . . 362 
Iron, Pyrophosphate of 362 
Irritable Ulcer, 823 
Itch, 693 
J 
Jalap, 334 
Jalapin, 334 
Jaundice, [ 577 
Jeiunum, 
Jellies, | 343 
Jessamine, Yellow, . . . 327 355 
Juglandin, ’ 335 
K 
Keratitis, 654 
Kidneys, I 513 
Kidneys, Bright’s Disease of the . 768 
Kidneys, Chronic Inflammation of the 767 
Kidneys, Inflammation of the . . 766 
Knee-joint, Tuberculosis of the . 444 
Knot-Root, 345 
li 
Labyrinth, or Internal Ear, . .. 106 
Lacerated Wounds, .... 815 
Lachrymal Fistula, .... 674 
Lachrymo-Nasal Tube, Obstruction 
of the 674 
Lacteals, 50 
Lady’s Slipper, .... 328, 352 
Laryngitis, Acute .... 482 
Laryngitis, Chronic .... 482 
Larynx, 62 
Larynx, Disease of the . . . 468 
Latent Life, 9 
Laudanum, 318 
Laxatives, 334 
Lemon Juice, 343 
Leptandrin, 335 
Leucocythsemia, 423 
Leuoorrhoea, 730 
Lichen, 689 
Life in a Latent Condition, . . 10 
Life Line, 167 
Life-Root, 348 
Ligamentum Denticulatum, . .89 
Light, 378 
Light and Health, . . . .242 
Liniments, 349 
Liquor Ammonia, .... 356 
Liver, 44,513 
Liver Complaint, 566 
Liver, Derangement of the . . 502 
Liver, Diseases of the . . . 562 
Lobelia, 347 
Logwood, 328 
Loss of Sexual Bower, . . . 798 
Love, 193 
Lumbar Abscess 441 
Lung Fever, 506 
Lungs, 62 
Lupulin, 320, 352 
Lycopin, 331 
Lymphatics, 50 
Lymphatic System, .... 51 
Lymphatic Temperament, . . 154 
M 
Macrotin, 314 
•Mad Dog-Weed, 352 
Magnetic Bath, 368 
Malaria, 237 
Male Fern, 322 
Male Reproductive Organs, Abuse of 
the 788 
Malformation of the Vagina, . . 712 
Malted Beverages, .... 261 
Malted Beverages, Objections to their 
Use, 262 
Mal-treatment of the Liver, . . 569 
Mandrake, 311 
Man is a Social Being, . . .289 
Maple-wood Ashes 343 
Marriage, . ... 193 
Marsh-Mallow, 344 
Marsupial Generation, . . . 214 
Masturbation, 790 
Masturbation a Fruitful Cause of Dis- 
ease in Women. 744 
Masturbation, Indication of, in Young 
Boys, 792 
May-Apple, 311 
May-Weed, 342 870 
INDEX. 
o 
Obscene Literature, . . . .290 
Obstruction of the Eustachian Tube, 681 
Obstruction of the External Ear, . 683 
Obstruction of the Lachrymo-Nasal 
Tube or Tear-Duct, .... 674 
Old Sores, 822 
Onanism, 790 
Onyxis, 706 
Opacities of the Cornea, . . . 656 
Ophthalmia, 643 
Ophthalmia Infantium Purulenta, . 647 
Ophthalmia Tarsi, .... 675 
Ophthalmoscope 665 
Opium, 318 
Opium, Use of . . . , . 384 
Orange Juice, 343 
Organic Diseases of the Heart, . 524 
Organic Headache, .... 630 
Organs of Respiration, ... 62 
Origin of Life, 19 
Os Hyoides, 25 
Osseous Tissue, 22 
Osteitis, 825 
Osteoid Cancer, 454 
Otalgia, 678 
Otorrhoea, 679 
Ovarian Tumors, 764 
Ovaries, Tumors of the . . .762 
Oviparous Generation, . . .213 
Ovi-viviparous Generation, . . 214 
Ovulation, 221 
Ox-Balm, 345 
Ozsena, 465, 466 
P 
Pain, . 397 
Painful Menstruation,.... 719 
Painters’ Colic, 558 
Pancreas, 46 
Pancreatic Juice, 78 
Papular Rash, 689 
Paralysis, 618 
Paralysis of the Auditory Nerves, . 684 
Paregoric, 318 
Parotitis, 461 
Passive Congestion of the Brain, . 614 
Patella, 29 
Patients Visited at a Distance, . 864 
Peach Tree, 355 
Peduncles of the Cerebellum, . . 99 
Pelvis, 27 
Pemphigus, 698 
Penis, 218 
Pennyroyal, 
Pepper, Black, 356 
Peppermint, 333 
Percussion, 392, 494 
Pericarditis, 526 
Pericardium, 57 
Perichondrium, 30 
Periosteum, 29 
Peritonitis, 547 
Permanganate of Potash, . . .326 
Perpetuation of the Species, . . 204 
Perspiration, 73 
Pertussis, 
Phalanges, 28, 29 
Pharynx, 
Phthisis Pulmonalis, . 487 
Physical Culture, 274 
Physical Labor Modifies the Passions, 288 
Physician, Liberal or Independent, 297 
Physicians, to .... 864 
Physiological Anatomv, 
™ .•, 21, 32 39, 49, 57, 62, 67, 73, 81, 85 
Physiological Marriage, . . . 184 
Meadow Sweet, 331 
Measles, 414 
Meat, Boiled 254 
Medical Diagnosis, .... 391 
Medical Treatment of Spermatorrhoea 
and Impotency, 806 
Medicated Baths, 372 
Medicine, Properties of 308 
Medicines, List of .... 310 
Medicine, The Application of Cere- 
bral Physiology and Temperaments 
to the Successful Practice of . . 186 
Medicines, The Preparation of . 309 
Medulla Oblongata, .... 92 
Medullary Cancer, .... 453 
Melanoid Cancer, .... 454 
Meningitis, 614 
Menorrhagia, 724 
Menses, Cessation of the . . .727 
Menstruation, .... 221, 513 
Menstruation and its Disorders, . 711 
Menstruation, Painful, . . .719 
Menstruation, Profuse, . . .724 
Mental Culture, .... 274, 280 
Mental Culture in Childhood, . . 281 
Mercurials, 375 
Metacarpus, 28 
Metatarsus, 29 
Microscopical Examination, . . 400 
Miliaria, 698 
Milk, 77 
Miscarriage, 752 
Modes of Dioecious Reproduction, . 213 
Monogamy, 797 
Moral Considerations, .... 802 
Morphine, ' 379 
Motherwort, 348 
Mouth, 39 
Mucous Diarrhoea, . . . .550 
Mucus, 76 
Mumps, 467 
Muriated Tincture of Iron, . . 362 
M uriatic Acid 318 
Muscles, 32 
Muscular Rheumatism, . . . 429 
Muscular Tissue, .... 22 
Mustard, 339 
Mutton, Baked 255 
Mutton Soup, . . . . . .254 
N 
Narcotics, 350 
Nasal Catarrh, Chronic, . . . 465 
Nasal Douche, 477 
Nasal Polypus, 480 
Natural Drink of Man, . . .256 
Nature of Mind, 743 
Necrosis, 826 
Nephritis, 766 
Nerve, The Pneumogastric . . 94 
Nervines, 357 
Nervous Affections of the Skin, . 699 
Nervous Headache, .... 630 
Nervous System, 85 
Nervous Tissue, 22 
Nettle-Rash, 696 
Neuralgia 628 
Neuralgia of the Heart, . . . 527 
Neuralgia of the Stomach, . . 537 
Night-sweats, .... 494, 501 
Nitre, Spirits of 346 
Nocturnal Emissions, .... 795 
Nurse, 
Nursing Sore Mouth, . 537 
Nursing the Sick, 375 
Nux Vomica, . . . . . 353 
Nymphomania, 744 871 
INDEX. 
Physiology, 9 
Phytolaccin, ...... 312 
Pia Mater, 89 
Pigeon-Berry, 312 
Rifes, 596 
Pine-Apple Juice, .... 343 
Pink-Root, 322 
Pipsissewa, 343 
Pityriasis, 688 
Placenta or Afterbirth, . . . 227 
Pleasant Purgative Pellets, . 316, 336 
Pleurisy, Acute, ..... 516 
Pleurisy-Root, 340 
Pneumogastric Nerve, ... 94 
Pneumonia, 506 
Podophyllin, 312 
Poisoned Wounds, . . . 815, 818 
Poisons and their Antidotes, 820, 821, 822 
Poison Hemlock, 319 
Poison Parsley, 319 
Poke, 312 
Polygamy, 197 
Polypus, Nasal 480 
Polypus, Uterine 763 
Polyuria, 769 
Poplar, White Aspen .... 323 
Populin, 323 
Pork Steaks, 255 
Position of Patient, .... 395 
Posterior Pyramids, .... 93 
Pox, 783 
Preface, 5 
Pregnancy, Disorders Incident to . 765 
Pregnancy, Duration of 230 
Pregnancy, Right to Terminate, . 229 
Pregnancy, Signs of ... 230 
Preparation of Food, .... 246 
Prevention of Conception,. . . 224 
Prickly-Ash, 356 
Pride-Weed, 332 
Prince’s Pine, 343 
Process of Generation, . . .13 
Profuse Menstruation,. . . .724 
Prognosis, 391 
Progress of Medicine,. . . .293 
Prolapsus Ani, 603 
Prolapsus or Falling of the Uterus, . 755 
Proprietary Medicines, . . .301 
Prostate Gland, 218 
Prurigo, 700 
Pruritus Vulvas, 731 
Prussian Blue, 323 
Pseudo-Hygiene, 270 
Psoas Abscess, 441 
Psoriasis, 688 
Pterygium, 670 
Pulmonary Tuberculosis, . . .487 
Pulsatilla, 352 
Pulse, 397 
Pulse, Frequency of the . . .501 
Pumpkin Seeds, 346 
Pure Air, 378 
Purgatives, 334 
Purification of Water, . . . .259 
Purulent Conjunctivitis, . . . 645 
Purulent Discharge from the Ear, . 679 
Purulent Inflammation of the Eye, . 645 
Purulent Ophthalmia of Newborn 
Children, 647 
Pyrophosphate of Iron, . . .362 
a 
Queen of the Meadow, . . .343 
Questions to Invalids,.... 854 
Quickening, 229 
Quinine, 323 
Quinsy, 418 
It 
Rachitis, 447 
Radius, 28 
Rational Medicine, . . . 293 
Rattle-Root, 313 
Rectum, 43 
Red Puccoon-Root, ... 314 
Reflex Action of tne Spinal Cord, . 90 
Regional Divisions, .... 119 
Region of Feebleness 130 
Regularity of Meals, .... 244 
Reliable Medicines, . . . .860 
Remedies for Disease, . . . 301 
Remittent Fever, 408 
Reproduction, 206 
Respiration, Organs of ... 62 
Respiration, Pure Air for . . . 234 
Respirator, Cotton-Wool, . . . 241 
Retention and Suppression of the 
Menses from Anajmia, . . . 715 
Retention and Suppression of the 
Menses from Morbid Conditions of 
the Blood, 714 
Retina, 103 
Retroversion of the Uterus, . .757 
lthagades Ani, 611 
Rheumatic Synovitis, .... 444 
Rheumatism, 428 
Rhubarb, 335 
Ribs, 25 
Rich-Weed, 345 
Rickets, 447 
Riding on Horseback, .... 278 
Ringworm, 698 
Rose-Rash, 415 
Rowing, ....... 277 
Rosy Drop, 692 
Rubeola, 414 
Running 277 
Running Scall, 686 
Running Sores 822 
Rupia, 699 
Rupture, 828 
Russian Bath, 365 
S 
Sacrum, 27 
Saffron, 340 
Sage, 321, 340 
Salseratus, 317 
Salicin, 323 
Saliva, 76 
Salivary Glands, 40 
Salt, Common, 322 
Saltpetre, 346 
Salt-rheum, 686 
Salts, Epsom 336 
Sanguine Temperament, . . . 161 
Santonin, 321 
Sarcolemma, 33 
Sassafras-pith, 343 
Scabies, 693 
Scald-Head, 701 
Scalds, 819 
Scall, 691 
Scaly Skin Diseases, . . . .700 
Scapula, 27 
Scarlatina, 410 
Scarlet Fever, . . . . . 410 
Scirrhus Cancer, 452 
Sclerotic, 103 
Scott’s Acid Bath, .... . 872 
Scrofula, 434 
Scrofulous Conjunctivitis, . . . 647 
Scrofulous Diathesis, .... 434 
Scrofulous Inflammation, . . . 647 
Scrotum, 218 872 
INDEX. 
Scull-Cap, 352 
Scurvy, .448 
Scutellarin, 352 
Sea Bathing, 369 
Sebaceous Glands, 69 
Sebaceous Matter, 75 
Secretion, 73 
Sedatives, 353 
Self-abuse, 291, 790 
Self-Pollution, 790 
Seminal Fluid, . . . . 218, 794 
Seminal Weakness, . . . .793 
Sequestrotomy, 827 
Serous Diarrhoea, 550 
Sexual Abuse, Story of 396 
Sexual Desire, 790 
Sexual Influences, .... 383 
Sexual Power, Loss of 798 
Shock, 815 
Shower Bath, 370 
Sight, 102 
Sick Headache, 631 
Sick Room, 377 
Simple Inflammation of the Eye, . 643 
Site for Homes, 237 
Sitz Bath, 371 
Skating 277 
Skin, 67, 512 
Skin, Diseases of the .... 685 
Skin, Nervous Affections of the . 699 
Skoke, 312 
Sleep, 274, 282,382 
Sleep, Amount of 285 
Sleeping Alone, 283 
Sleeping Rooms, 283 
Sleep, Position in , . . . . 284 
Sleep, Time for 283 
Slippery-elm Flour, .... 343 
Small-Pox, 411 
Small-Pox, Modified, .... 413 
Smart-Weed, Compound Extract of 
. . . 320, 334, 341, 348, 349, 357 
Smell, 107 
Smooth Alder, 312 
Snake-Head, 322 
Softening of the Mucous Coat of the 
Stomach, 533 
Solitary Indulgence, .... 790 
Sore Mouth, 530 
Soups, Beef, Mutton, . . . .254 
Spasmodic Croup, . . . .487 
Spearmint, 333 
Special Senses, 102 
Speculum, Uterine . . . .761 
Spermatic Duct, 218 
Spermatorrhoea, 793 
Spermatorrhoea, Evidences of the 
Curability of 808 
Spermatorrhoea in Women, . . 744 
Spermatorrhoea, Medical Treatment 
of 806 
Sperm Cell, 10 
Spinal Column, ..... 26 
Spinal Cord 88 
Spirea, 331 
Spirits of Nitre, 346 
Spirit Vapor Bath, .... 366 
Spirometer, 393 
Spleen, 45 
Sponge Bath, 370 
Spotted Fever, 615 
Squaw-Root, 313 
Staphyloma, 658 
Sterility, 735 
Sternum, 25 
Stimulants, 355 
Stomatitis, . . . . . .530 
Stomatitis Materna, . . . .531 
Stone in the Bladder, . . . .772 
Stone-pock, 702 
Stone-Root, 345 
Stomach, 41 
Strabismus, 672 
Stramonium, 351 
Stricture of the Intestinal Canal, . 501 
Stricture of the Urethra. . . . 783 
Structural Diseases of the Stomach, 533 
Structure of the Testicle, . . . 789 
Strumous Diathesis, .... 434 
Strumous Synovitis .... 444 
St. Vitus’s Dance, 626 
Stye, 675 
Styptics, 818 
Submaxillary Gland, .... 40 
Sudoriferous Glands, .... 68 
Superficial Layer of Muscles on the 
Anterior Portion of the Body, . 35 
Superficial Layer of Muscles on the 
Posterior Portion of the Body, . 87 
Sulphite of Soda, . . . '. . 317 
Sulphur Bath, 372 
Sulphur Vapor Bath, . . . .372 
Summer Complaint, . . . 549, 582 
Sun-stroke, 819 
Suppers, Late . . . . .241 
Swamp Alder, 312 
■Swelled Testicles, 782 
Sweet Elder, 315 
Swimming, . ... . . 278 
Sycosis, 702 
Symptoms, Interpretation of . .395 
Symptoms of Disease, . . . .394 
Symptoms of Spermatorrhoea, . . 799 
Synovial Membrane, .... 30 
Synovitis, 443 
Syphilis, 778, 783 
Syphilitic Synovitis, .... 444 
T 
Tag Alder, 312 
Tall Speedwell 335 
Tamarind Juice, 343 
Tannin, 333 
Tansy, 348 
Tarsus, 29 
Taste, 108 
Tea, 260 
Tear-Duct, Closure of the . . . 469 
Tear-Duct, Obstructions of the . . 674 
Tears, 75 
Teeth, 39 
Temperaments Classified, . . . 154 
Temperate-Bath, 364 
Tepid-Bath, 364 
Terms for Treatment,. . . . 861 
Testicles, Swelled. . . ... 782 
Testicle, Structure of the . . . 789 
Thick Neck, 460 
Thoracic Duct, ... . .44 
Throat, Diseases of the . . . 467 
Thoroughwort, 324 
Thorn-Apple, 351 
Thoughts Addressed to Invalids, . 831 
Thrush, 530 
Tibia, 29 
Tinctures, 310 
Tobacco, Use of . . . . •. 384 
Tongue, 40, 397 
Tonics, 357 
Tonsilitis, 418 
Tonsils, Enlarged, . . . .419 
To Physicians, ..... 864 
Torpid Liver, 566 
Touch, 109 INDEX. 
873 
Tourniquet, 816 
Trachea, 62 
Trailing Arbutus 344 
Transmission of Life, . . . i 182 
Treating Patients who Beside at a 
Distance, 841 
Trichiasis, 676 
Trichina Spiralis, 588 
Trumpet-Weed, 343 
Tubercle, 434 
Tubercular Consumption, . . . 487 
Tuberculosis of the Knee-joint, . 444 
Tumors of the Lids, .... 676 
Tumors of the Uterus and Ovaries, 762 
Tunica Arachnoid*, .... 89 
Turkish-Bath, 365 
Turn of Life, 727 
Tympanum, Affections of the . . 682 
Typhoid Fever, 409 
Typhus Fever, 409 
V 
Ulceration of the Cornea, . . . 657 
Ulceration of the Uterus, . . . 760 
Ulcer, Follicular 761 
Ulcer, Granular 760 
Ulcers, 822 
Ulna, 28 
Umbilical Cord, 228 
Umbilical Hernia, .... 828 
Universality of Animalcular Life, . 18 
Ureters, 217 
Urethra, 218 
Urethra, Stricture of the . . . 783 
Urinary and Generative Organs, Fe- 
male, 217 
Urinary and Generative Organs, Male, 
218 
Urinary Deposits, .... 770 
Urinary Organs, Diseases of the . 766 
Urinary Signs, 843 
Urine, Examination of the . . 399 
Urine, Incontinence of 775 
Urticaria, 696 
Uterine Derangements, . . . 502 
Uterine Pregnancy, .... 226 
Uterine Speculum, . . . .761 
U terus, 217 
Uterus, Anteflexion of the. . . 757 
Uterus, Anteversion of the. . . 758 
Uterus, Flexions and Versions of the 756 
Uterus, Prolapsus or Falling of the 755 
Uterus, Betroversion of the . . 757 
Uterus, Tumors of the . . .762 
Uterus, Version of the . . . 757 
Uvula, Elongation of the . . . 420 
V 
Vaccinia, 413 
Vagina, 217 
Vaginal Injections, .... 734 
Vaginitis, 731 
Valerian, 326 
Valvular Lesions, 525 
Vapor Bath, 368 
Variations and Personal Dissimilari- 
ties, 18 
Varicella, 414 
Varicocele, 797 
Varicose Ulcer. . . . . 823 
Variola, 411 
Varioloid, 413 
Vegetable Acids, 343 
Veins, 59 
Venereal Debauchment, . . . 790 
Venereal Diseases, .... 778 
Ventilation of Factories and Work- 
shops, 236 
Ventilation of our Dwellings, . . 237 
Ventilation of School Booms, . . 235 
Versions of the Uterus, . . 756, 757 
Vesical Calculi, 772 
Viburnin, 328 
Virginia Snake-Boot, . . . .341 
Visiting Patients who Beside at a 
Distance, 864 
Visiting the Sick, 383 
Vital and Non-Vital Temperaments, 150 
Vitriol, White 326 
Viviparous Generation, . . . 214 
Volitive Faculties, . . . .125 
Volitive Temperament, . . . 169 
Voluntary Pollution, .... 790 
Vulvitis, 731 
W 
Wafer-Ash, 361 
Warm Bath, 364 
Warmth, 379 
Warts, 705 
Water, 255 
Water as a Bemedial Agent, . . 363 
Water-Bugle, 331 
Water-Hoarhound, .... 331 
Water-Melon Seeds, .... 345 
Water, Mineral Impurities of . . 257 
Water, Organic Impurities of . . 258 
Welfare of Society, .... 202 
Wet Sheet Pack, ... .373 
White Hellebore, 354 
White Poplar, .... 323, 357 
White-Boot, 340 
Whites, .730 
White Swelling, 443 
White Vitriol, 326 
White Wood, 357 
Whitlow, 708 
Whooping-Cough, .... 518 
Why Our Fees are Bequired in Ad- 
vance, 861 
Wild Chamomile, 342 
Wild Hairs, • 676 
Wild Indigo, 326 
Wild Yam, 328 
Willow, 359 
Wintergreen, 333 
Winter Pink, 344 
Witch-Hazel, 329 
Woman and her Diseases,. . . 710 
Words from Patients, .... 810 
Worms, 584 
Wounds, 815 
X 
Xanthoxylin, 356 
Y 
Yeast, 325 
Yellow Dock, 312 
Yellow Jessamin. .... 327, 355 
Yellow Lady’s Slipper, . . . 328 APPENDIX. 
WORLD’S DISPENSAKY. 
The above Institution, located at Nos. 80, 82, 84 and 86 West Seneca 
Street, (Corner of Terrace,) Buffalo, N. Y., established 
for the cure of all 
CHRONIC DISEASES 
PARTICULARLY THOSE OF A 
DELICATE, OBSCURE, COMPLICATED OR 
OBSTINATE CHARACTER, 
Also, for the skillful performance of 
SURGICAL OPERATIONS, 
AND AS A DEPOT FOR 
DR. PIERCE’S FAMILY MEDICINES, 
Is the largest establishment of its kind in the world. It is organized 
with an eminent Staff of Physicians and Surgeons, each devoting his 
whole time and attention to some particular branch of practice, by 
which the greatest skill is attained. 
R. V. PIERCE, M. D., 
World's Dispensary, Buffalo, N. Y. 876 
APPENDIX. 
YOICE OF THE PRESS. 
A Mammoth Establishment and an Enter- 
prising Proprietor. 
It is hardly necessary for us to call attention to the whole page com- 
munication from Dr. R. Y. Pierce, of the World’s Dispensary, which 
appears in this issue, as at least every invalid suffering from Chronic 
Disease must see and take a lively interest in the sound, common-sense 
ideas therein set forth, as well as in the indisputable evidences of won- 
derful cures that are given. 
From the Buffalo Sunday News. 
Buffalo has several business establishments of which she may justly 
feel proud, hut few, if any indeed, that have acquired such world-wide 
fame and reputation as that of Dr. Pierce—“ The Worlds Dispensary.” 
This establishment well merits its appellation, as it is, without doubt, 
the largest and most complete of its kind that can he found any- 
where, and medicines are prepared within its walls that find a ready 
sale in every quarter of the globe. In fact the foreign trade forms 
no small part of the business. On a visit to the Doctor’s establishment, 
not long since, we were shown an order just received from one of 
his foreign customers, amounting to the nice little sum of $10,225.60. 
The Doctor’s pamphlets and books have been translated and published 
in German, Spanish and other foreign languages. As an evidence of 
the magnitude of the business carried on at the World’s Dispensary, we 
would state that the sum expended for postage alone, for the quarter 
ending March 31st, 1874, and not including that paid on newspapers 
received, which is very large, foots up $2,080.70. The World’s Dispen- 
sary is located on the corner of West Seneca Street and the Terrace, and 
the mammoth five story building and basement is entirely occupied from 
basement to roof. Nearly a hundred hands, men, boys and girls, are 
employed in the several departments, and yet extensive machinery with 
all the latest improvements, has been introduced by the enterprising 
proprietor to facilitate the work and lessen the amount of manual labor. 
Even the washing and filling of bottles is done by machinery and with 
the greatest dispatch. In the pamphlet binding department we also 
noticed four folding machines which are kept in constant operation and 877 
APPENDIX. 
turn out as much work as some seventy or eighty girls could do in the 
ordinary way without machinery. We also noticed cutting, ti’imming 
and stitching machinery, all of the most modern and improved kind. In 
the printing department are several cylinder and Gordon presses, and 
they ax-e all kept running at the height of their speed the year round. 
The machinery is all furnished with power from a ery large engine on 
the first floor. The building throughout is heated by steam fi-om the 
boiler located in the basement, and one of those very necessary articles, 
a steam elevator, connects the different stoi-ies. The manufacturing and 
putting-up departments are veiy extensive, and the most perfect system 
and order prevail everywhere. Everything looks clean, neat and tasty, 
and the roots, barks and herbs used ai-e all of the choicest selection, as 
the Doctor is determined that the high reputation that his Family Medi- 
cines have acquii-ed shall not suffer for lack of uniformity of strength 
and purity. Each department is in charge of a most cai-eful and com- 
petent superintendent, and in the manufacturing department the utmost 
care is exercised to prevent any deviation fi-om established rules for the 
prepai-ation of the medicines. 
A visit to the shipping department, which is on the first floor, gives 
one a slight idea of the colossal proportions of the business there trans- 
acted. Here the visitor may see, as we did, huge piles of boxes being 
shipped to wholesale houses in every part of the land, also to foreign 
countries — even China and Japan contributing to the demand for these 
popular medicines. The Doctor has achieved this immense patronage 
and demand for his celebrated remedies by his great skill as a physician, 
the superior curative virtues of the remedies he has discovei’ed, and his 
honorable dealings, indomitable will and ceaseless industry. The cures 
that he has effected have often been wonderful, in fact almost miraculous, 
having frequently been accomplished, as he has shown us ample evidence, 
after many eminent physicians in succession had failed. This success 
has had the effect to give him an immense practice at the World’s Dis- 
pensary, so that in a single month he probably treats and cures more 
cases of inveterate Chronic Diseases than most physicians, in ordinary 
practice, treat in a whole life-time. His practice has become so large 
that he is obliged to employ physicians to assist him in the examination 
and treatment of cases. And in the selection of his professional assist- 
ants he has spared no expense to secure men of thorough medical educa- 
tion, and who have been well skilled in the school of experience. Each 878 
APPENDIX. 
devotes his whole time and attention to a specialty, while Doctor Pierce, 
who has not only received degrees from at least two of the first medical 
colleges in the land, the evidence of which, in the shape of diplomas,we 
noticed hanging in his office, hut has also the advantage of an immense 
experience and is in constant consultation with them over the more dif- 
ficult cases. Thus the patient has not only the benefit of Doctor Pierce’s 
large experience, but also that of a Council of Physicians, each skilled 
in his particular specialty. Besides all these assistant physicians, in the 
Dispensary Department are also employed short-hand reporters to assist 
in correspondence, and dispensing or drug clerks, each skilled in his 
business, that the Doctor’s prescriptions may be compounded with the 
greatest care. Whoever has observed, as we have, the crowd of patients 
almost constantly in the reception rooms at the World’s Dispensary, and 
has heard the heartfelt expressions of gratitude and praise which they 
lavishly bestow upon the honorable and worthy proprietor, cannot fail 
to agree with us, that the diligent medical devotion, patient industry and 
unconquerable energy that have enabled Doctor Pierce to achieve so 
much, have at the same time conferred a real blessing upon suffering 
humanity. We publish the above, not as a “paid puff,” but only as a 
fair representation of one of the first business men of the land, whose 
fame is becoming world-renowned, and whose enterprise contributes in 
no small degree to the prosperity of this city, giving employment to 
large numbers, and in various other ways promoting the general welfare 
of the people. 
From the Toledo Blade. 
Success is never achieved without merit. A man may take a poor 
article and sell it once, and, there being 40,000,000 people in the United 
States, the sale to each one would be enough to make a decent fortune. 
But an article that holds the field year after year, and the sales of which 
increase regularly and rapidly, must have absolute merit. 
Dr. 11. V. Pierce, of Buffalo, N.Y., occupies our entire eighth page 
to-day with his various articles. We admit it because we know the Doc- 
tor and know of his articles. We know him to be a regularly educated 
physician, whose diploma hangs on the wall of his office, and we know 
that he has associated with him several of the most eminent practitioners 
in the country. We know that parties consult him, by mail and in per- 
son, from all the States in the Union every day, and that they are faiily APPENDIX. 
879 
and honestly dealt with. We know that his medicines are sold in enor- 
mous quantities in every State in the Union, and that they are now the 
leading specifics in South America and Mexico, and are beginning to 
gain a foothold in Europe. 
This grand result has been accomplished by two agencies — good, reli- 
able articles— articles which, once introduced, work, easily, their own 
way — and splendid business management. They have succeeded be- 
cause they ought to succeed. 
•“Here comes that Advertising Sheet again. Why, just see here, a 
whole page given to an advertisement of Dr. Pierce’s Patent Medicines.” 
Now let us have a word confidentially with you. We have been send- 
ing out hills to subscribers for amounts due from one to five years, and 
in some cases even more, and we can discover no increase in our receipts 
by mail. We want to send these persons the paper, and believe they 
are honest, good, church-going people, and will pay, only they think we 
can wait, and so they wait. Well, here comes Dr. Pierce and buys the 
privilege of a whole page and pays liberally for the same before even 
the type is set; he thus helps among other advertisers to send you the 
paper, and yet you complain that we are curtailing the reading matter 
of the paper you are paying C ?J for; you say, “we will not stand it, we 
will pay up and quit, and take some paper that does not advertise.” Very 
good, we hope you will. There will he enough of those left who do pay 
to read it, and it is to those we wish to excuse ourselves, yet we think it 
hardly necessary, as being sensible people, from the fact of having 
paid their subscriptions, they will appreciate the state of the case, and 
say we do well in our endeavors to send the paper to those unfortunates 
who, from some cause, in a few cases, perhaps, from inability, are un- 
able to pay for their paper. We advise them, the delinquents, to read 
Dr. Pierce’s advertisement, it is quite voluminous. He has certificates of 
remarkable cures, &c. We have not read it over, hut perhaps the Doc- 
tor advertises some cure for “Delinquent Newspaper Subscribers,” and 
by reading it they, as well as ourselves, may he benefited. We doubt, 
nowever, if a cure for such a disease should be advertised,whether some 
would take it, so great is their disgust for patent medicine advertisements 
and paying up subscriptions. Could Dr. Pierce, or some other doctor, 
discover a cure for the disease above mentioned, he would find many 
From the Baltimore Episcopal Methodist. 880 
APPENDIX. 
weary, oppressed and down-hearted newspaper men ready to rise up and 
call him blessed, yea, even more, they would insert all his advertisements 
free, of this, as well as of other cures, so grateful would they be. 
Among the notable physicians of this country, Dr. R. V. Pierce, of 
Buffalo, stands deservedly high. He has obtained professional eminence 
through strictly legitimate means, and fully deserves the enviable repu- 
tation which he enjoys. A thorough and careful preparation for his 
calling, and extensive reading during a long and unusually large prac- 
tice, have made him extraordinarily successful in his private practice, 
and gained the commendation even of his professional brethren. By 
devoting his attention mainly to certain specialties he has been rewarded 
in a very great degree, and in these lines is recognized as a leader. Not 
a few of his preparations compounded for these special cases have been 
adopted and are used in their private practice by physicians throughout 
the country, and his pamphlets and larger works upon these subjects 
have been welcomed as valuable additions to materia medica, and placed 
among the regular text-books of many medical schools. Acknowledg- 
ment of the services which he has performed for medical science has 
been made by presentations of degrees from two of the first medical 
institutions of the land, and by the translation of several of his works 
into German, Spanish and other foreign languages. The increasing 
demand for his specifics sometime since necessitated the opening of 
a regular Dispensary for their preparation, and from a small begin- 
ning the business of this establishment has now grown to mammoth 
proportions. 
From the Republican, of St. Louis, Mo. 
From the Chicago Times. 
The name of Dr. R. V. Pierce has become as familiar to people all 
over the country as household words. His wonderful remedies, his 
pamphlets and books, and his large medical experience have brought 
him into prominence and given him a solid reputation. The Times, in 
the present issue, presents a whole-page communication from Dr. 
Pierce, and our readers may gain from it some idea of the vast propor- 
tions of his business and the merits of his medicines. He has at Buffalo 
a mammoth establishment, appropriately named “The World’s Dispen- 
sary,” where patients are treated, and the remedies compounded. Here APPENDIX. 
881 
nearly an hundred persons are employed in the several departments, 
and a corps of able and skilled physicians stand ready to alleviate the 
sufferings of humanity by the most approved methods. These physicians 
are in frequent consultations with Dr. Pierce, and their combined 
experience is brought to bear on the successful treatment of obstinate 
cases. The doctor is a man of a large medical experience, and his 
extensive knowledge of materia medica has been acknowledged by pre- 
sentations of degrees from two of the first medical colleges in the land. 
How meritorious his works are may be inferred from the fact that his 
pamphlets and books have been translated into German, Spanish, and 
other foreign languages, and have been in heavy demand. 
From the Baltimore Episcopal Methodist. 
In the city of Buffalo, N. Y., there is to be found an institution of 
large dimensions, very appropriately called “The World’s Dispensary,” 
where remedies are compounded and where those suffering from the ills 
that flesh is heir to, receive treatment for their ailments. Every body 
has heard of Dr. Pierce, of Buffalo, N. Y.; if any of our readers have 
not, we give them an opportunity of reading something in reference to 
him, his medicines, and his establishment in our issue of this week. Dr. 
Pierce, we learn, is a man of large medical experience, his thorough 
knowledge of materia medica has been acknowledged by various medical 
institutions of the land. Two of the leading schools of medicine of this 
country have presented him with diplomas. His treatises have been 
translated into the German, Spanish, and several other foreign lan- 
guages, facts highly indicative of their merit. 
Not every man who advertises medicines must be put down as a quack. 
—Here is a man of acknowledged ability—he wishes to benefit his race, 
he cannot call individually on the sufferers, but he tells where they may 
come and how they may be cured; he publishes his medicines, is 
endorsed by Doctors, and has certificates of cures, etc. We must not 
class him among quacks—men who sell bread pills on the street corners, 
and retire from observation after they have gulled the people and 
pocketed their money. No, we must not mention him in connection 
with these. Dr. Pierce’s establishment is too large to pull down in a 
day, it is a fixed thing, and his reputation is too highly established to be 
even doubted. 882 
APPENDIX. 
The advance pages from a new work by It. Y. Pierce, M. D., have 
attracted our attention. The work is entitled “The People’s Medi- 
cal Adviser,” and is designed to give to the masses that general knowl- 
edge of the causes of disease and the means of prevention which should 
ever be the honest physician’s handmaiden, but which is so rarely at 
hand to second his efforts. Its object is not to supersede, but to supple- 
ment, his work; yet we think that an intelligent application of the 
knowledge here given to the world would often obviate the necessity for 
the visits of the professional, who thrives upon our afflictions. Judging 
from the candid and simple style of these miscellaneous pages, we 
cheerfully commend the book to the public as the work which should 
be in the hands of every person on whom the health of others depends 
in any degree whatever. By this we mean not only those whose calling 
places them beside the sick-bed, but mothers also, and housekeepers, 
that they may know what regulations to make for the individuals com- 
posing their households and what kinds and quantities of food to admin- 
ister for the building of strong frames and healthy brains. The issue 
of a large first edition enables the publisher to fix the small sum of $1.50 
as the price of so much information. Dr. Pierce has a wide reputa- 
tion as the founder of the World’s Dispensary at Buffalo, N. Y., and this 
new venture is not likely to cause a leaf to drop from his laurel crown. 
From the La Salle (III.) Reporter 
From the Independent, Chebanse, 1U. 
It is coming. What is coming ? A new book. What book ? A book 
that should be in every household. What is the name of it? “The 
People’s Medical Adviser,” by K. V. Pierce, M. D., Buffalo, N. 
Y., Counselor-in-Chief of the Board of Physicians and Surgeons at the 
World’s Dispensary. Of all the knowledge that may be acquired, 
how to preserve the health and prevent disease is of paramount import- 
ance to every individual. Advance sample pages of the above work are 
now upon our table. * * * No man stands higher in his profes- 
sional attainments than the author. He is a man of the people— 
understands the wants of the people — and is laboring for the good 
of the whole people. The above work is written in very simple terms 
and any one who can read at all can understand it and should possess 
a copy. APPENDIX. 
883 
“The People’s Common Sense Medical Adviser, in Plain En- 
glish, or Medicine Simplified,” by E. Y. Pierce, M. D., etc., etc. Ad- 
vance pages of the foregoing book have been laid on our table, and 
after an examination we feel warranted in saying that the language of 
the book is indeed “in plain English,” while the ideas regarding disease 
and its treatment seem entirely plausible. We have for a long time 
thought that a book would yet be produced which the common under- 
standing could reach, and which families of average intelligence might 
consult to advantage. If Dr. Pierce has succeeded in making such a 
book, and it seems quite likely that he has, it will have a wide sale and 
be productive of vast good. There is no reason why books on health 
and medicine, and especially how to avoid disease, should not come 
into general use in the families of our country. 
From the Central Protestant, Greensboro, N. C. 
We have received advance pages of a forthcoming work entitled, 
“The People’s Common Sense Medical Adviser, in Plain English, 
or Medicine Simplified,” by R. Y. Pierce, M. D., of the World’s 
Dispensary, at Buffalo. The pages before us embody a clear, concise 
and comprehensive discussion of the life-giving elements, and it is 
evident that the work will find its way into and be prized by many 
households. 
From the Dansville Express, Dansville, N. Y. 
From the Troy Daily Times, Troy, N. Y. 
The Common Sense Medical Adviser, in Plain English, or 
Medicine Simplified. By K.. Y. Pierce, M. D., Counselor-in-Chief 
of the Board of Physicians and Surgeons at the World’s Dispensary. 
Buffalo: World’s Dispensary Printing Office. 
Every family needs a Common Sense Medical Adviser, and the book 
here noted is intended to fill a very important place. It embraces a 
wide range of subjects, all of them bearing with more or less directness 
upon the all-important question of health. Biology, physiology, the 
cerebral functions, the human temperaments, and hygienic treatment, 
or nursing of the sick, receive that attention which their relative impor- 
tance demands. Physical and mental culture, ventilation, sleep, clean- 
liness, food, beverages and clothing are practical topics and are treated 
in a practical manner. Under the head of remedies for diseases is pre- 
sented a list of our most useful indigenous medicinal plants, together 884 
APPENDIX. 
with their properties and uses and pictorial representations of many of 
the most important. The appropriate dose of each remedy is also given. 
After a suitable introduction, there is in Part Fourth diseases and their 
remedial treatment. Chronic ailments receive special attention. A 
chapter on accidents and emergencies is a very useful feature of the 
book. Beside this, much miscellaneous and profitable information is 
given, which will make it a genuine “vade mecum”—a convenient 
companion in every household. Many a precious life has been lost from 
the lack of just the knowledge which this work imparts. A healthy 
moral sentiment pervades the whole work, which fact commends it to a 
place in the family. 
From the Jewish Times, New York. 
Dr. R. Y. Pierce, of Buffalo, is just about to publish a work, en- 
titled: “The People’s Common Sense Medical Adviser.” We 
have received some advance sample pages of this work, which evince 
deep thought, originality and careful investigation; the subjects are 
treated in an easy and comprehensive manner, the use of technical terms 
having been avoided as far as possible. We have no doubt that it will 
turn out a most valuable book, eminently adapted to the wants and 
tastes of the people; instructive to the masses in the branches of Physi- 
ology, Hygiene and Domestic Medicine; a book which will soon become 
popular, and which will reflect great credit upon its author. 
From the Saratoga Sun, Saratoga Springs, N. Y. 
“The People’s Common Sense Medical Adviser, in Plain 
English, or Medicine Simplified.”—This is the title of a very 
valuable new book by R. Y. Pierce, M. D., of Buffalo. It is such a 
book as should be in every family, and as all men and women, old and 
young, should read, and cannot fail to receive a great amount of prac- 
tical knowledge from. It is a book that will make the reader acquainted 
with himself—the greatest stranger in the world to most people. It is 
better and wiser to know how to preserve the health when well, than to 
know how to restore it when sick. This book tells how to do both. It 
is written in the most plain, simple, chaste and comprehensive language, 
in words and terms that all may fully know the meaning of. Both 
health and morality are essential elements in the real progress of man- 
kind ; and this book, while it discusses in a philosophic spirit the truths APPENDIX. 
885 
and principles concerned in the preservation of health, shows their true 
relation to the sphere of morals. Consequently, an elevated moral tone 
pervades the entire work. While it minutely and scientifically discusses 
the origin, conditions and perpetuation of life, and the mysterious forces 
which are concerned in the growth and development of man, yet it does 
not cater to depraved tastes, perverted passions, or idle curiosity, hut 
thoroughly considers all physiological subjects, a proper knowledge of 
which acquaints us with the means for preserving health and furnishes 
incentives to a higher and nobler life. 
People’s Medical Adviser.—We have received some advance 
pages of a new medical work of the above title, by R. Y. Pierce, 
M. D., of Buffalo, Is. Y., and from a cursory examination, we confess 
to a decidedly favorable impression. Dr. Pierce has gained an enviable 
notoriety in the successful treatment of many complicated diseases, and 
in the work before us proposes to give the world the benefit of his skill 
and experience. The hook is framed ostensibly in accordance with the 
dictates of common sense (by the way, the most uncommon of all sense), 
and seems to he clear and intelligible in its teachings, systematic in 
arrangement, and withal printed with new, clear and beautiful type, on 
paper of best quality, and must prove quite a desideratum for every 
household, especially as it will he furnished postpaid at the low price 
of $1.50 per copy. 
From the Canton (Mo.) Press.